Krupa Mariusz
Klinika Neurochirurgii i Neurotraumatologii Uniwersytetu Jagiellońskiego Collegium Medicum ul. Botaniczna 3, 31-503 Kraków.
Ann Acad Med Stetin. 2009;55(3):13-9.
The second part of this review is concerned with methods and results of treatment in chronic subdural hematoma (CSDH). Surgical evacuation is the generally accepted approach to treatment in CSDH. There are two neurosurgical methods of evacuation: 1. Burr hole in the cranial vault and evacuation of hematoma fluid. 2. Craniotomy and removal of hematoma with surrounding membranes. According to the literature, priority should be given to burr hole evacuation of the hematoma on the following premises: 1. High effectiveness with lower risk of complications and better treatment outcome for trepanation. 2. Craniotomy with removal of hematoma membranes, although radical, does not eliminate the risk of recurrence of hematoma. 3. Reduction in the volume of hematoma fluid through the burr hole and drainage may lead to total resorption of hematoma together with membranes.
本综述的第二部分关注慢性硬膜下血肿(CSDH)的治疗方法及结果。手术引流是CSDH普遍认可的治疗方法。有两种神经外科引流方法:1. 颅骨钻孔并引流血肿液。2. 开颅并切除血肿及周围包膜。根据文献,在以下前提下应优先选择钻孔引流血肿:1. 有效性高,并发症风险低,钻孔治疗效果更佳。2. 开颅切除血肿包膜虽然彻底,但不能消除血肿复发的风险。3. 通过钻孔减少血肿液体积并引流,可能导致血肿连同包膜完全吸收。