Sun J, Wang W, Wang D, An S, Xue L, Wang Y, Zhu S G, Jiang R C, Yang X J, Yue S Y
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Tianjin 300052, China.
Zhonghua Yi Xue Za Zhi. 2017 May 23;97(19):1502-1504. doi: 10.3760/cma.j.issn.0376-2491.2017.19.015.
To investigate the clinical characteristics, pathogenesis and surgical strategy for the chronic subdural hematoma associated with arachnoid cyst (AC). Ten patients of chronic subdural hematoma associated with AC were retrospectively enrolled from the Neurosurgery Department of Tianjin Medical University General Hospital from January 2012 to September 2015, with a mean age of 27.5±5.6 years (range, 18-37 years). All patients simply performed a burr hole drainage of hematoma and left the AC intact, then followed up for 12 to 18 months after discharge respectively. In this study, the AC in 8 of 10 cases occurs in the middle cranial fossa, and the other 2 cases root in the cerebral hemisphere.The AC of 10 patients all locate near the hematoma cavity.Nine patients had a full recovery, and only one patient had a recurrent subdural hematoma with a secondary operation, then recovery in 3 months postoperation.All patients lived completely free of neurological symptom and showed no recurrence in the follow-up period with a Barthel index more than 90. Simply burr hole drainage of hematoma and leave intact AC achieves satisfied outcome and provides a reliable therapy strategy for chronic subdural hematoma associated with arachnoid cyst.
探讨蛛网膜囊肿(AC)合并慢性硬膜下血肿的临床特点、发病机制及手术策略。回顾性纳入2012年1月至2015年9月天津医科大学总医院神经外科收治的10例AC合并慢性硬膜下血肿患者,平均年龄27.5±5.6岁(范围18 - 37岁)。所有患者均单纯行血肿钻孔引流术,AC未处理,出院后分别随访12至18个月。本研究中,10例患者中8例AC位于中颅窝,另外2例起源于脑半球。10例患者的AC均位于血肿腔附近。9例患者完全康复,仅1例患者复发硬膜下血肿并二次手术,术后3个月康复。所有患者均无神经症状,随访期间无复发,Barthel指数均大于90。单纯血肿钻孔引流术且保留AC完整可取得满意疗效,为AC合并慢性硬膜下血肿提供了可靠的治疗策略。