蛛网膜囊肿合并慢性硬膜下血肿10例临床分析

Clinical Analysis of Arachnoid Cysts with Chronic Subdural Hematoma—10 Case Reports

目的:探讨蛛网膜囊肿合并慢性硬膜下血肿的诱因及治疗方案。方法:青岛大学附属医院2014年4月至2020年5月收治蛛网膜囊肿合并慢性硬膜下血肿患者10例,2例保守治疗,3例行单纯钻孔引流术,1例行囊肿–腹腔分流术 + 钻孔引流术,1例行钻孔引流术 + 开颅血肿清除术,3例行开颅血肿清除术 + 囊肿切除术,回顾性分析其临床资料和治疗效果。结果:10例患者均恢复良好,无不适,3~24个月随访未见血肿或囊肿复发。结论:蛛网膜囊肿患者受头部外伤、运动等刺激易致囊肿破裂出血;蛛网膜囊肿合并慢性硬膜下血肿首选钻孔引流术;血肿复发或囊肿伴相应症状者可在行血肿清除时一并切除囊肿。

Objective: To investigate the pathogenesis and treatment of intracranial arachnoid cyst. Methods: Retrospectively analyze 10 patients with arachnoid cysts and intracranial hematoma admitted from April 2014 to May 2020. 2 patients were managed conservatively, 3 patients were performed with trepanation and drainage, 1 patient was performed with borehole drainage and cystic-peritoneal shunt, 1 patient was performed with borehole drainage and hematoma evacuation, 3 patients were performed with hematoma evacuation and cyst resection. Results: All the patients in this study were in good recovery and respectively followed up for 3 to 24 months. No complications or recur-rence had occurred. Conclusion: Patients with intracranial arachnoid cysts are vulnerable to intra-cranial hemorrhage after head injury or sports. Trepanation and drainage should be the first treatment of arachnoid cysts with chronic subdural hematoma. Craniotomy evacuation of hemato-ma and cyst resection are preferred to the patients who have high risk of bleeding recurrence or obvious symptom of arachnoid cysts.