性别对慢性硬膜下血肿发生的影响；这是颅骨不对称的作用吗？
Influence of Gender on Occurrence of Chronic Subdural Hematoma; Is It an Effect of Cranial Asymmetry?
作者信息
Oh Jae-Sang, Shim Jai-Joon, Yoon Seok-Mann, Lee Kyeong-Seok
机构信息
Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
出版信息
Korean J Neurotrauma. 2014 Oct;10(2):82-5. doi: 10.13004/kjnt.2014.10.2.82. Epub 2014 Oct 31.
OBJECTIVE
Chronic subdural hematoma (CSDH) is a condition mostly present in older people. Men are more commonly affected than women. Several theories about male predominance could not enough to explain the reason for male predominance on CSDH. The purpose of this study is to find out whether there were any differences in the anatomy of cranium, which may contribute the pathogenesis or risk factors of CSDH.
METHODS
The study population was consisted of 87 patients with CSDH and 100 patients with transient ischemic attack (TIA) from 2006 to 2013. We classified into four groups; group A (CSDH male 47), group B (CSDH female 40), group C (TIA male 50), and group D (TIA female 50). We measured the size of the cranium in the computed tomography scans, retrospectively. We define the difference of cranium (Dc), which is difference between the right and left radiuses.
RESULTS
The Dc was significantly higher in patients with CSDH (group A and B)(p=0.03). The mean Dc was 3.49 mm in CSDH group (group A and B) and 2.14 mm in TIA group (group C and D). The mean Dc of CSDH group was significantly larger than that of TIA group (by t-test, p<0.01).
CONCLUSION
Size and asymmetry of the cranium may be a risk factor of CSDH. Gender differences in the anatomy of cranium may contribute pathogenesis of CSDH.
目的
慢性硬膜下血肿（CSDH）多见于老年人，男性比女性更易患病。关于男性优势的几种理论不足以解释CSDH中男性占优势的原因。本研究的目的是找出颅骨解剖结构是否存在差异，这可能有助于CSDH的发病机制或危险因素。
方法
研究人群包括2006年至2013年的87例CSDH患者和100例短暂性脑缺血发作（TIA）患者。我们分为四组：A组（CSDH男性47例），B组（CSDH女性40例），C组（TIA男性50例），D组（TIA女性50例）。我们回顾性地在计算机断层扫描中测量颅骨大小。我们定义颅骨差异（Dc），即左右半径之间的差异。
结果
CSDH患者（A组和B组）的Dc显著更高（p=0.03）。CSDH组（A组和B组）的平均Dc为3.49mm，TIA组（C组和D组）为2.14mm。CSDH组的平均Dc显著大于TIA组（通过t检验，p<0.01）。
结论
颅骨的大小和不对称可能是CSDH的危险因素。颅骨解剖结构的性别差异可能有助于CSDH的发病机制。
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