Seizeur Romuald, Abed-Rabbo Francis, Obaid Sami, Saliou Philippe, Simon Alexandre, Dam Hieu Phong, Magro Elsa
a Service de Neurochirurgie, Hôpital Cavale Blanche , CHRU Brest , France.
b Université de Brest , France.
Br J Neurosurg. 2017 Apr;31(2):258-261. doi: 10.1080/02688697.2016.1220503. Epub 2016 Sep 29.
Chronic subdural haematomas (CSDH) is a common pathology that usually affects the elderly population. The incidence of CSDH has recently been increasing with the expansion of the aging population. The objective of our study was to evaluate the outcome following surgical drainage of CSDH in elderly patients.
We performed a retrospective analysis of 455 consecutive patients with CSDHs over a 5-year period. Among them, all 121 patients older than 80-year old were included in the study. Clinical status, comorbidities, type of surgical technique and outcome were analyzed. Outcome at last follow-up was measured using the Markwalder grading score and the Glasgow outcome scale.
Patients ranged from 80- to 94-year old with a median age of 84 years (range 80-94). Ninety-eight percent of patients were surgically treated by a small burr hole under assisted local anaesthesia. About 69.2% of patients improved post-operatively. The mortality rate was 6.8%.
CSDH is a common pathology in the elderly population. Patients with CSDHs often have comorbodities that need to be considered in deciding whether surgical treatment is indicated. When surgery is elected, small craniostomy techniques performed under assisted local anesthesia is safe and should be favored in this frail population.
慢性硬膜下血肿（CSDH）是一种常见的病理情况，通常影响老年人群。随着老年人口的增加，CSDH的发病率最近一直在上升。我们研究的目的是评估老年患者CSDH手术引流后的结果。
我们对5年内连续的455例CSDH患者进行了回顾性分析。其中，所有121例年龄超过80岁的患者被纳入研究。分析了临床状况、合并症、手术技术类型和结果。末次随访时的结果使用Markwalder分级评分和格拉斯哥预后量表进行测量。
患者年龄在80至94岁之间，中位年龄为84岁（范围80 - 94岁）。98%的患者在局部麻醉辅助下通过小骨孔进行手术治疗。约69.2%的患者术后病情改善。死亡率为6.8%。
CSDH是老年人群中的常见病理情况。CSDH患者通常有合并症，在决定是否进行手术治疗时需要考虑这些合并症。当选择手术时，在局部麻醉辅助下进行的小骨窗开颅技术是安全的，并且在这个脆弱的人群中应优先采用。
