Spallone A, Giuffrè R, Gagliardi F M, Vagnozzi R
Department of Neurosciences, University of Rome La Sapienza, Italy.
Eur Neurol. 1989;29(1):18-22. doi: 10.1159/000116370.
445 cases of chronic subdural hematomas have been operated on during the last 35 years (1951-1986). The ages of the patients ranged from 14 to 91 years and averaged 54 years. Two groups of patients were considered and compared: (A) extremely aged patients, who were over 75 years old, and (B) patients in their sixth decade of life whose age was in fact close to the mean age of chronic subdural hematoma patients in our experience. There were 35 cases (8% of the total number of cases) in group A and 113 cases (26%) in group B. Presumably etiological trauma was less severe in elderly patients who more frequently showed a background of hormonal derangement, such as liver and/or prostatic disease. Bilateral hematomas were detected more frequently in older patients. They usually presented with mental retardation, unlike younger patients who more frequently had symptoms and signs of increased intracranial pressure. Early postoperative complications occurred more frequently in older patients. However, this did not preclude obtaining good results in more than three quarters of them. The implications of these findings are discussed.
在过去35年（1951 - 1986年）间，共对445例慢性硬膜下血肿患者进行了手术治疗。患者年龄从14岁至91岁不等，平均年龄为54岁。我们将患者分为两组并进行比较：（A）高龄患者，年龄超过75岁；（B）60多岁的患者，其年龄实际上接近我们经验中慢性硬膜下血肿患者的平均年龄。A组有35例（占病例总数的8%），B组有113例（占26%）。推测老年患者的病因性创伤较轻，他们更常伴有激素紊乱背景，如肝脏和/或前列腺疾病。老年患者双侧血肿的检出率更高。他们通常表现为智力减退，而年轻患者更常出现颅内压升高的症状和体征。老年患者术后早期并发症的发生更为频繁。然而，这并不妨碍超过四分之三的老年患者获得良好的治疗效果。本文对这些发现的意义进行了讨论。
