外伤性慢性硬脑膜下血肿发生机理探讨

Study of Pathogenetic Mechanism of Traumatic Chronic Subdural Hematoma

目的 探讨慢性硬脑膜下血肿(CSDH)的发生机理。方法 对我科1997年至1999年治疗的17例急性硬脑膜下血肿(ASDH),11例CSDH及9例硬脑膜下积液病人进行观察分析。结果 17例ASDH非手术治疗后无1例发展成为CSDH。9例硬脑膜下积液有2例发展成为CSDH,1例发展为张力性硬脑膜下积液。11例CSDH病人中,在第一次外伤后72h内头部CT示6例硬脑膜下积液,4例脑挫伤,1例无特殊显示,无一例为硬膜下血肿。结论 CSDH的发生可能与硬脑膜下积液有密切关系。

Objective To explore the pathogenetic mechanism of traumatic chronic subdural hematoma (CSDH). Method Data of 17 patients with acute subdural hematoma (ASDH), 11 patients with CSDH and 9 patients with subdural collection of fluid (SDCF) were analysed retrospectively. Results None of the 17 patients with ASDH developed CSDH after active conservative treatment. Of the 9 patients with SDCF, 2 developed CSDH and 1 tensile subdural collection of fluid. The first CT scan within 72 hours after the brain injury showed that of 11 patients with CSDH, 6 had SDCF, 4 cerebral contusion and 1 was normal. Conclusion The pathogenesis of CSDH was correlated probably with SDCF.