Sakai N, Nokura H, Deguchi K, Decarlini E, Futamura A, Yamada H
Department of Neurosurgery, Gifu University School of Medicine, Japan.
Childs Nerv Syst. 1990 Dec;6(8):447-50. doi: 10.1007/BF00302091.
Thirty-four cases of infantile subdural effusion (ISE) were reviewed in relation to surgical treatment and its prognosis during an average of 4 years of extended follow-up. The surgical indications were determined mainly by the size of the ISE on computed tomography (CT) scan and by metrizamide CT cisternography (MCTC). Consequently, 18 cases were categorized as type A according to MCTC, including 11 cases (61.1%) of ISE CT grade 1. All type A cases were closely observed. This nontreatment regimen yielded excellent results in 15 cases (83.3%). For 10 cases categorized as type B according to MCTC, including 5 cases (50%) of ISE CT grade 3, surgical treatment was indicated and excellent results were obtained in 8 cases (80%). For 6 cases categorized as type C according to MCTC and as ISE CT grade 3, surgery yielded excellent results in 4 cases (66.7%). Antiepileptic drugs have been given to three (27.3%) of the 11 patients who had convulsive attacks. In conclusion, the surgical indications for ISE were based mainly on MCTC in addition to the clinical course, and it is emphasized that, in the early stages, surgery on ISE cases categorized as MCTC types B and C is necessary.
回顾了34例婴儿硬膜下积液（ISE）病例在平均4年的长期随访期间的手术治疗情况及其预后。手术指征主要根据计算机断层扫描（CT）上ISE的大小以及甲泛葡胺CT脑池造影（MCTC）来确定。因此，根据MCTC，18例被归类为A型，其中包括11例（61.1%）ISE CT 1级病例。所有A型病例均密切观察。这种非治疗方案在15例（83.3%）中取得了优异的结果。对于根据MCTC归类为B型的10例病例，其中包括5例（50%）ISE CT 3级病例，进行了手术治疗，8例（80%）取得了优异的结果。对于根据MCTC归类为C型且为ISE CT 3级的6例病例，手术在4例（66.7%）中取得了优异的结果。11例有惊厥发作的患者中有3例（27.3%）接受了抗癫痫药物治疗。总之，ISE的手术指征除临床病程外主要基于MCTC，并且强调在早期阶段，对归类为MCTC B型和C型的ISE病例进行手术是必要的。
