Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ 85013, USA.
J Clin Neurosci. 2013 Oct;20(10):1398-401. doi: 10.1016/j.jocn.2013.01.010. Epub 2013 Jul 31.
We compared the histopathological features of the outer membrane of a chronic subdural hematoma (CSH) with its clinico-radiological presentation in patients. One hundred and fifty-six patients undergoing surgery for CSH were prospectively included in this study. Histopathological specimens of the outer neomembrane obtained intraoperatively were studied. Histological features were classified into four types and analyzed in relation to the Glasgow Coma Scale (GCS) score at presentation and radiological features. On histopathological examination, there were no cases of type I, 42.3% cases of type II and 34.6% cases of type III and 23.1% cases of types IV CSH neomembranes. Patients presenting with a GCS <13 exclusively had type II neomembranes. Increased radiodensity and thickness of the hematoma correlated with type IV neomembranes. This study may serve as an incentive to investigate the histopathology of CSH membranes in predicting outcomes and the recurrence of subdural hemorrhage after drainage surgery.
我们比较了慢性硬脑膜下血肿(CSH)患者外膜的组织病理学特征与其临床放射学表现。本研究前瞻性纳入了 156 例因 CSH 而行手术治疗的患者。术中获得的外膜组织病理学标本进行了研究。将组织学特征分为 4 型,并与入院时格拉斯哥昏迷量表(GCS)评分和影像学特征进行分析。组织病理学检查发现,无 I 型病例,II 型占 42.3%,III 型占 34.6%,IV 型占 23.1%。GCS<13 的患者仅存在 II 型外膜。血肿的放射密度和厚度增加与 IV 型外膜相关。本研究可能有助于研究 CSH 膜的组织病理学,以预测引流手术后的结果和硬膜下血肿的复发。