Steimlé R, Jacquet G, Godard J, Fahrat O, Katranji H
Service de Neurochirurgie, Hôpital Jean-Minjoz, Besançon.
Chirurgie. 1990;116(2):160-7.
The pathogenesis of chronic subdural hematoma, especially the reason why it becomes chronic is still under discussion. A series of 80 patients older than 60 years (47% older than 75 years) were studied clinically and by CT. As compared with angiography, CT allows the subdural hematoma to be detected earlier. In some cases the subdural hematoma might have been missed without CT. The indication for surgery remains unchanged and surgical techniques too. In 80% of the patients good results from the clinical point of view could be achieved. There was no correlation between clinical signs and the findings obtained by CT. Postoperatively it usually took 60 to 70 days for CT findings to disappear. The prognosis of subdural hematoma in the elderly remains guarded. The mortality rate in our series was 11% possibly as a consequence of age.
慢性硬膜下血肿的发病机制，尤其是其为何会发展为慢性的原因仍在探讨之中。我们对80例年龄在60岁以上（47%年龄超过75岁）的患者进行了临床和CT研究。与血管造影相比，CT能够更早地检测到硬膜下血肿。在某些情况下，若没有CT，硬膜下血肿可能会被漏诊。手术指征和手术技术均保持不变。从临床角度来看，80%的患者取得了良好的效果。临床体征与CT检查结果之间没有相关性。术后CT检查结果通常需要60至70天才能消失。老年人硬膜下血肿的预后仍不容乐观。我们所研究的系列病例中的死亡率为11%，这可能是年龄所致的结果。
