Tagle Patricio, Mery Francisco, Torrealba Gonzalo, Del Villar Sergio, Carmona Hans, Campos Manuel, Méndez Jorge, Chicharro Ada
Departamento de Neurocirugía y Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Rev Med Chil. 2003 Feb;131(2):177-82.
The lack of specificity and heterogeneity of the clinical picture of chronic subdural hematoma, hampers its diagnosis.
To report the experience of a Neurosurgical Service in chronic subdural hematoma.
One hundred patients (77 male, mean age 77 +/- 13 years) with chronic subdural hematoma were analyzed.
The main clinical presentations were mental status changes (50%) and progressive focal neurological deficit (46%). Five cases presented as a transient neurological deficit. All patients were treated with burr hole drainage. Thirteen had recurrence of the hematoma and they were reoperated. The surgical mortality was 3%. Eighty seven patients were followed for a mean of 66 months. Eighty one of these had a complete recovery, 6 had permanent neurological deficit and 2 of these were unable to care for themselves. Bad prognosis was associated with the absence of a previous trauma to explain the hematoma and symptoms of dementia as the clinical presentation.
Most patients with chronic subdural hematoma treated with burr hole drainage have a good outcome.
慢性硬膜下血肿临床表现缺乏特异性和异质性，妨碍了其诊断。
报告神经外科治疗慢性硬膜下血肿的经验。
分析了100例慢性硬膜下血肿患者（77例男性，平均年龄77±13岁）。
主要临床表现为精神状态改变（50%）和进行性局灶性神经功能缺损（46%）。5例表现为短暂性神经功能缺损。所有患者均接受钻孔引流治疗。13例血肿复发并再次手术。手术死亡率为3%。87例患者平均随访66个月。其中81例完全康复，6例有永久性神经功能缺损，2例生活不能自理。预后不良与无既往外伤史来解释血肿以及以痴呆症状为临床表现有关。
大多数接受钻孔引流治疗的慢性硬膜下血肿患者预后良好。
