Haselsberger K, Pucher R, Auer L M
Universitätsklinik für Neurochirurgie, Graz, Austria.
Acta Neurochir (Wien). 1988;90(3-4):111-6. doi: 10.1007/BF01560563.
In a series of 171 patients suffering acute subdural haemorrhage (SDH) (111 patients) or epidural haemorrhage (EDH) (60 patients) after closed head injury accumulated during the years 1978-1985 at the University Hospital of Graz, the mortality rate and the grade of clinical recovery were evaluated. The overall mortality in acute SDH was 57%, in acute EDH 25%, the percentages of good recoveries--full recovery and minimal neurologic deficit--25 and 58%, respectively. Outcome was found to be predominantly influenced by the preoperative state of consciousness, associated brain lesions, and, in comatose patients, the duration of the time interval between onset of coma and surgical decompression. When this interval exceeded two hours, mortality from SDH rose from 47 to 80% (good outcomes 32 and 4%, respectively). In acute EDH an interval under two hours lead to 17% mortality and 67% of good recoveries compared to 65% mortality and 13% of good recoveries after an interval of more than two hours. Age and concomitant injuries of other body regions proved to be of secondary importance.
1978年至1985年间，格拉茨大学医院收治了一系列171例闭合性颅脑损伤后发生急性硬膜下血肿（SDH）（111例）或硬膜外血肿（EDH）（60例）的患者，对其死亡率和临床恢复程度进行了评估。急性SDH的总体死亡率为57%，急性EDH为25%，恢复良好（完全恢复和仅有轻微神经功能缺损）的比例分别为25%和58%。结果发现，主要影响因素为术前意识状态、合并的脑损伤，对于昏迷患者而言，还包括昏迷发作至手术减压的时间间隔。当该间隔超过两小时，SDH的死亡率从47%升至80%（恢复良好的比例分别为32%和4%）。在急性EDH中，间隔两小时以内的死亡率为17%，恢复良好的比例为67%，而间隔超过两小时后的死亡率为65%，恢复良好的比例为13%。年龄和身体其他部位的合并损伤被证明是次要因素。
