Soto-Granados Mauro
Hospital Militar Regional de Acapulco, Guerrero, Mexico.
Cir Cir. 2010 May-Jun;78(3):203-7.
Chronic subdural hematoma (CSH) is usually a cranial encephalic trauma present in 1/100,000 cases in subjects >70 years old. We undertook this study to report the experience obtained in the treatment of CSH using the technique of evacuation of the hematoma through a burr hole, irrigation and closed system drainage under local anesthesia.
We performed a retrospective and descriptive study from 1999 to 2008. Files of clinical and radiological diagnoses of adult patients with CSH were reviewed and corroborated with computed axial tomography (CAT) and who were subjected to drainage of the CSH.
Seventeen patients were surgically intervened (average age: 72 years). All patients were male and there was a history of trauma in all. Three of the 17 patients had been subjected to an aggression. The average time between injury and symptom onset was 6 weeks. According to the scale of Markwalder, 65% were classified as grade I, 29% as grade II and 6% as grade III. According to CAT, most of the bruises were hypodense and unilateral. As to the effect of the mass according to the scale of Gordon-Firing, 82% were classified as grades II and III.
Treatment of CSH through a burr hole, irrigation and closed system drainage under local anesthesia is simple, safe and effective.
慢性硬膜下血肿（CSH）通常是一种颅脑创伤，在70岁以上的人群中发病率为1/100,000。我们开展这项研究以报告采用钻孔引流血肿、冲洗及局部麻醉下封闭系统引流技术治疗CSH的经验。
我们进行了一项1999年至2008年的回顾性描述性研究。回顾了成年CSH患者的临床和放射学诊断档案，并通过计算机断层扫描（CAT）进行了核实，这些患者均接受了CSH引流治疗。
17例患者接受了手术干预（平均年龄：72岁）。所有患者均为男性，且均有外伤史。17例患者中有3例曾遭受攻击。受伤至症状出现的平均时间为6周。根据Markwalder量表，65%被分类为I级，29%为II级，6%为III级。根据CAT检查，大多数瘀伤为低密度且为单侧。根据Gordon-Firing量表评估肿块的影响，82%被分类为II级和III级。
局部麻醉下通过钻孔、冲洗及封闭系统引流治疗CSH简单、安全且有效。
