Hasegawa M, Yamashima T, Yamashita J, Suzuki M, Shimada S
Department of Neurosurgery, Kanazawa University School of Medicine, Japan.
Neurosurgery. 1992 Sep;31(3):580-5. doi: 10.1227/00006123-199209000-00024.
Five patients with traumatic subdural hygroma are reported with reference to its pathology and meningeal enhancement on magnetic resonance imaging. Hygromas showed initially iso- and, later, high intensity on both T1- and T2-weighted images compared with the intensity of the cerebrospinal fluid. In all cases of the thick hygromas, magnetic resonance imaging with gadolinium diethylene-triamine-pentaacetic acid showed meningeal enhancement. Intravenously injected radioisotope immediately flowed into the hygromas, but computed tomographic cisternography and gross inspection during the surgery showed no evidence of an influx of cerebrospinal fluid into the hygromas. Microscopic examination of the enhanced meninges revealed vascularized neomembrane with numerous fenestrations and pinocytosis underneath the dura mater. It is suggested from these data that the subdural neomembrane is associated with the development of the traumatic subdural hygromas. Meningeal enhancement would be useful to clarify the growing mechanism of traumatic subdural hygromas.
本文报告了5例创伤性硬膜下积液患者，并参考其病理学及磁共振成像上的脑膜强化情况进行分析。与脑脊液信号相比，积液在T1加权像和T2加权像上最初呈等信号，随后呈高信号。在所有厚壁积液病例中，钆喷酸葡胺磁共振成像显示脑膜强化。静脉注射放射性同位素可立即流入积液内，但计算机断层脑池造影及手术中的大体检查均未发现脑脊液流入积液的证据。对强化脑膜进行显微镜检查发现，硬脑膜下有血管化的新膜，有许多窗孔及胞饮现象。从这些数据推测，硬膜下新膜与创伤性硬膜下积液的形成有关。脑膜强化有助于阐明创伤性硬膜下积液的生长机制。
