Tsuboi K, Maki Y, Nose T, Matsuki T
No Shinkei Geka. 1984 Mar;12(3 Suppl):275-9.
Thirty-two cases with chronic subdural hematoma in adults were analyzed from two standpoints; one is the characteristics of pre- and post-operative psychiatric symptoms, the other is the common factors in patients with post-operative psychiatric symptoms. The average age of subjects was 55.4 years, and psychiatric symptoms were noticed in 18 cases (56%). Main pre-operative psychiatric symptoms were disorders of intellectual capacity including memory and orientation disturbance and were able to be classified into amnestic syndrome and dementia according to DSM-3. Outcome in amnestic group was good in contrast to that in dementia group mostly complicated by post-operative psychiatric symptoms. Post-operative psychiatric symptoms were seen in 6 cases. The average age of these cases was 68.2 years which was higher than that of asymptomatic group. And these were classified as dementia according to DSM-3. Common factors in these 6 cases were as follows: Accompanied by marked pre-operative psychiatric symptoms. High age. Complicated by post-operative subdural fluid collection with certain mass effects. Long period from head injury to operation. Accompanied by other complications such as cirrhosis of liver and hypertension. Subdural fluid collection following surgery is a problem under discussion. We obtained favorable results by subdural-peritoneal shunt.
从两个角度对32例成人慢性硬膜下血肿病例进行了分析：一是术前和术后精神症状的特点，二是术后出现精神症状患者的共同因素。研究对象的平均年龄为55.4岁，18例（56%）出现精神症状。术前主要精神症状为智力障碍，包括记忆和定向障碍，根据《精神疾病诊断与统计手册》第三版（DSM-3）可分为遗忘综合征和痴呆。与大多伴有术后精神症状的痴呆组相比，遗忘组的预后较好。6例出现术后精神症状。这些病例的平均年龄为68.2岁，高于无症状组。根据DSM-3，这些被归类为痴呆。这6例的共同因素如下：术前伴有明显精神症状。高龄。并发术后硬膜下积液并有一定的占位效应。从头部受伤到手术的时间较长。伴有其他并发症，如肝硬化和高血压。术后硬膜下积液是一个正在讨论的问题。我们通过硬膜下-腹腔分流术取得了良好的效果。
