慢性硬膜下血肿性痴呆患者临床及影像学特征及其转归

Clinical and imaging features of patients with chronic subdural hematoma dementia and their outcomes

目的:探讨慢性硬膜下血肿性痴呆的临床表现、影像学特点及与治疗后痴呆转归的关系。方法:回顾性分析临床资料完整且经CT或MRI检查确诊的40例慢性硬膜下血肿性痴呆病例。并与同期的20例慢性硬膜下血肿非痴呆老年患者的临床表现、影像学资料进行对照。结果:①慢性硬膜下血肿性痴呆多发生于老年人,且创伤史不明显(75%)。②临床表现为非特异性头晕(93%,37/40)、头痛(78%,3140),及智力、精神异常(P<0.05)。神经定位体征不明显,极易误诊为血管性痴呆或老年性痴呆,CT是有效快捷的诊断手段。③治疗及时预后一般良好。且早期手术患者轻瘫及智力障碍恢复较非手术组恢复快(P<0.05)。结论:慢性硬膜下血肿性痴呆是一种可逆性痴呆,及早进行诊断治疗,可降低致残率。

AIM:To investigate the relation among clinical manifestation,imaging features and dementia outcomes after treatment in patients with chronic subdural hematoma s dementia(CSHD). METHODS:Clinical data of 40 patients who were finally diagnosed as CSHD with C T or MRI were analyzed, as compared with non-dementia patients with chronic sub dural hematoma(CSH)(n=20). RESULTS:CSHD often occurred in the elderly,who had no evident injured history( 75%).Clinical manifestations were non-specific headache(78%,31/40)or dizzy(93 %,37/40), and abnormality of intelligence and mind(P< 0.05).Signs of neural loc ation were not obvious, and the patients were apt to be misdiagnosed as vascular dementia or senile dementia.CT was an effective way in diagnosis.Prognosis was better due to timely treatment.Patients operated earlier had faster recover from mild palsy and dysnoesia. CONCLUSION:CSHD is a kind of reversible dementia,and patients need to be diagn osed and treated as soon as possibleto reduce the rate of disability.