初诊为脑血管病的慢性硬膜下血肿52例临床分析

THE MISDIAGNOSTIC ANALYSIS OF 52 CASES WITH CHRONIC SUBDURAL HEMATOMA

目的 探讨慢性硬膜下血肿的临床特点、影像学改变及预后。方法 对 52例初诊为脑血管病的慢性硬膜下血肿的临床表现、CT与MRI等资料及预后进行分析。结果 52例初诊为脑梗死 40例 ,脑出血 1 0例 ,蛛网膜下腔出血 2例。平均年龄 65 .5岁 ,具有脑血管病的特点 ,外伤史较隐匿 ,CT和MRI确诊。手术治疗 37例 ,非手术治疗 1 5例 ,除 1例死亡外 ,余 51例均治愈。结论 慢性硬膜下血肿患者尤其老年患者易与脑血管病相混淆 ,详尽的病史调查及影像学检查有助于确诊。及时治疗预后良好。

Objective To investigate the clinical features, image diagnostics and prognosis of chronicsubdural hematoma (CSDH). Methods The clinical feature, CT, MRI and prognosis of 52 patients with CSDH whose prime diagnosis being cerebrovascular disease (CVD) were analysed. Resuits The prime diagnosis of 52 cases with CSDH were as follows, 40cases cerebral infarction, 10cases intracerebral hemorrhage, 2 cases subarachnoid hemorrhage(SAH). Their average age was 65.5 years old, with the features of CVD and dormant traumatic history and being diagnosed by CT and MRI. Of the 52 cases, 37 were treated by surgery operations, and 15 by non-operations. As a result, 52 cases were cured except 1 dead. Conclusion Clinical symptoms of CSDH in the elderly patients are not typical, and it is easy confused with CVD. Therefore, we should pay more attention to the investigation of traumatic history and examinations of image diagnostics.If treated in time, it would have a better prognosis.