外伤性硬膜下积液演变为血肿机制研究

已有越来越多的临床工作注意到头颅损伤后硬膜下积液(traumatic subdural hygroma，TSH)演变为慢性硬膜下血肿(chronic subdural hematoma，CSDH)。但这种转变的确切过程及CSDH的自然演化过程尚处于认识阶段。笔自2001年1月始对临床发现的130例TSH进行了CT追踪和随访，并对部分患进行了手术干预和组织学检查。本通过复习献并结合临床提出TSH演变为CSDH的机理。     

外伤性硬膜下积液演变血肿34例临床分析

目的:探讨外伤性硬膜下积液( TSE)演变慢性硬膜下血肿(CSDH)的机制、临床特点.方法:对我科34例外伤性硬膜下积液演变为慢性硬膜下血肿患者进行回顾性分析.结果:34例演变为慢性硬膜下血肿的时间为伤后35-155天,演变为血肿后症均加重,28例患者经钻空引流术均治愈.结论:TSE是CSDH形成的因素之一,中老年多见,对TSE患者应行动态观察CT或MRI,早期发现CSDH.     

Traumatic subdural hydroma developing into chronic subdural hematoma

Objective: To probe the incidence, pathogenesis and clinical characteristics of traumatic subdural hydroma (TSH) developing into chronic subdural hematoma(CSDH). Methods: We retrospectively analyzed the clinical data of 32 patients with TSH developing into CSDH and reviewed related literature. Results: 16.7 % of TSH developed into CSDH in this study. The time of evolution was from 22 to 100 days after head injury. All the patients were cured with hematoma drainage. Conclusions : TSH is one of the origins of CSDH. The clinical characteristics of TSH developing into CSDH follow that the ages of the patients are polarized, that the evolution often happens in the patients with small chronic hydromas and being treated conservatively, that the patients are usually injured deceleratedly and that the accompanying cerebral damage is often very mild.     

硬通道针钻孔引流治疗慢性硬膜下血肿142例报告

慢性硬膜下血肿(Chronic subdural hematoma以下简称CSDH)是神经外科领域中较常见的疾病,其治疗方法和技巧多种多样,但一般认为钻孔引流为……     

锥颅置SUBDURAL CATHETERTM管引流治疗慢性硬膜下血肿

慢性硬膜下血肿(chronic subdural hematoma,CSDH)是神经外科临床常见病,约占颅内血肿的10%.目前冲洗引流术已被广泛应用,是一种较可靠的方法.本院于2002年9月至2003年11月间,采用自制锥颅(槽手锥)器锥颅,置SUBDURAL CATHETERTM管(硬膜F专用引流管)闭试引流术治疗慢性硬膜下血肿22例,效果满意.现就SUBDURAL CATHETERTM管在慢性硬膜下血肿治疗中的应用介绍如下.     

单、双颅骨钻孔对慢性硬膜下血肿术后复发的影响

慢性硬膜下血肿（Chronic subdural hematoma,CSDH）是老年人常见病,钻孔引流术治疗效果较好。临床医师对钻孔数量的意见各异,有单孔及双孔之分。本院近5年来采用单孔或双孔钻颅引流术治疗CSDH74例。现将结果报告如下。     

慢性硬膜下血肿170例的诊治经验

慢性硬膜下血肿（chronic subdural hematoma，CSDH）是神经外科的一种常见病，好发于老年人。笔者从1997年5月至2008年5月收治了170例病人．现将临床诊断、治疗方法及体会报告如下。     

慢性硬膜下血肿术后复发的多因素分析及防治

慢性硬膜下血肿(chronic subdural hematoma,CSDH)好发于50岁以上老年人,约占颅内血肿10%,临床表现无明显特征,手术效果较好.但研究发现约5%～33%患者术后血肿复发[1].……     

慢性硬膜下血肿引流术后突发大出血3例报告

2002年4月至2004年6月,我院共采用钻孔引流术治疗慢性硬膜下血肿(chronic subdural hematoma, CSDH)36例,其中3例(8.3%)术后突发大出血,由于引流管留置合理,处理及时,预后良好,现报道如下.     

外伤性硬膜下积液的治疗体会

外伤性硬膜下积液(traumatic subdural effusion,TSH)是因颅脑损伤时,脑组织在颅腔内强烈移动,致使蛛网膜被撕破,脑脊液经裂孔流至硬脑膜下与蛛网膜之间的硬脑膜下间隙聚集而成,也称外伤性硬膜下水瘤.本院2000年至今共收治31例外伤性硬膜下积液,现将诊治体会报告如下.     

Percutaneous subdural tapping and subdural peritoneal drainage for the treatment of subdural hematoma

Different therapeutic approaches may be used in the treatment of chronic subdural hematoma because it is more fluid. Age-dependent characteristics of the calvarium allow for different treatment in children and adults. Treatment options are discussed.     

Mixed bacterial subdural empyema complicating subdural peritoneal shunt

Bilateral subdural empyema occurred in a nine-month-old boy with a subdural-peritoneal shunt. Because of the mixed composition of bacterial growths, representative of faecal flora, it is assumed that the infection originated from perforation of the bowel by the distal tip of the shunt catheter, although no abnormal abdominal signs or symptoms were noted.     

Posterior fossa subdural hygroma with supratentorial chronic subdural haematoma

Posterior fossa subdural hygromas are very rare. They tend to occur following direct occipital trauma. We present an unusual case of complex subdural hygroma of the posterior fossa, which was associated with a supratentorial chronic subdural haematoma. This developed after an apparently minor injury to the head. The unusual features of our case are discussed. We also review the literature and discuss the natural history and pathogenesis of subdural hygroma.     

Exteriorization of the subdural pocket for chronic recurrent subdural hematoma

The author describes a new operative method for treating chronic recurrent subdural hematoma. The subdural pocket is exteriorized so that it is in continuity with the subgaleal space through a limited extradural pocket and an L-shaped linear craniectomy. This procedure has been carried out in two patients with recurrent chronic subdural hematoma, both of whom made complete recoveries despite initial recurrence of the subdural hematoma.     

An implantable subdural drain for treatment of chronic subdural hematoma

We describe a drain that is implanted at operation for a chronic subdural hematoma. The drain provides access to the subdural space and can therefore be used for percutaneous aspiration of reaccumulation of subdural effusions.     

Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma

Summary Thirteen of 145 patients with post-traumatic subdural hygroma (SDHy) developed chronic subdural haematoma (CSDH) at the involved site over a period of 6 years. CSDHs were found at the site of SDHys with no history of further head injury at a mean interval of 56 days. It appeared that these 13 patients did not have any distinguishing clinical features early on. Old age and brain atrophy on CT scans do not seem to be reasonable causative factors in the evolution of SDHy into CSDH. Initial enlargement of subdural accumulations at an early stage of SDHy and a subsequent increase in density at a later stage may point to the development of CSDH from SDHy in some instances. Ten of these 13 CSDH cases underwent surgical drainage, and the remaining 3 cases received no specific management. All resolved completely. The prognosis was good in all patients. The possible mechanism for the evolution of SDHy into CSDH is discussed.     

Treatment of chronic subdural collection in infants by subdural peritoneostomy

Between 1980 and 1987, 50 chronics bilateral subdural collections in infants were treated by means of a subdural peritoneal shunt (unilateral in 48 cases, bilateral in 2 cases). In 2 patients with huge macrocranium the drains were left in situ. In the 48 others, the drains were removed after an average of 10 months. In these 48 cases, the drainages either bilateral (2 cases) or unilateral (46 cases) led to the disappearance of the collections; however, in 1 of these 48, a drain had to be reinserted due to the reproduction of the collection following the removal of the initial drainage. High level of C.S.F. protein content did not alter the peritoneal resorption. Obstruction of the catheter by a clot occurred in 3 cases with grossly bloody collections. Unilateral subdural peritoneal drainage for bilateral pericerebral collection is an efficient and safe treatment. The authors should advocate temporary external drainage only in the cases where the collection is grossly bloody.     

外伤性硬膜下积液演变成慢性硬膜下血肿的临床分析

本院自1993年1月至2003年1月,共收治外伤性硬膜下积液(TSE)135例,其中17例转化为慢性硬膜下血肿(CSDH)。现结合患者的临床资料和有关文献报道如下。1临床资料1.1一般资料:17例中,男12例,女5例;年龄1～10岁6例,11～60岁2例,60岁以上9例。受伤原因:坠落伤6例,打击伤3例,车祸伤8例。其中减速性损伤12例。患者均否认在外伤性硬膜下积液演变为慢性硬膜下血肿期间有头部再次受伤史。1.2临床表现:17例患者均表现为在外伤性硬膜下积液症状的基础上,出现症状加重或新症状、体征,或原症状、体征减轻或消失后再次出现或加重。患者演变为慢性硬膜下血…     

外伤性硬膜下积液演变的慢性硬膜下血肿

目的 探讨外伤性硬膜下积液演变为慢性硬膜下血肿的几率、机理和临床特点。方法 回顾性分析32例外伤性硬膜下积液演变为慢性硬膜下血肿患者的临床资料及有关文献。结果 本组16.7%的外伤性硬膜下积液病例演变为慢性硬膜下血肿;积液演变为血肿的时间为伤后22－100d;经钻颅血肿引流均治愈。结论 外伤性硬膜下积液是慢性硬膜下血肿的来源之一。发病年龄两极化,常发生在积液量少、保守治疗的慢性型病例中,致病方式常为减速性损伤及合并的颅脑损伤很轻微是外伤性硬莫膜下积液演变为慢性硬膜下血肿患者的临床特点。