Stone J L, Lang R G, Sugar O, Moody R A
Neurosurgery. 1981 May;8(5):542-50. doi: 10.1227/00006123-198105000-00005.
The authors report a series of 80 cases of traumatic subdural hygroma and discuss the clinical and radiological features, management, surgical results, and pathogenesis. Changes in mental status without focal signs of brain damage were noted in over 50% of the cases. A clinical course marked by stabilization without complete recovery of neurological function was found in over 40% of the cases of "simple hygroma." The lumbar cerebrospinal fluid often showed hemorrhage and elevation of the protein content. Skull fractures were found in 39% of the cases, and subdural hygromas were associated with cerebral atrophy, cortical contusions, subdural hematomas, and overlying epidural hematomas. The characteristic angiographic and computed tomographic scan findings are discussed, as are surgical pathology and outcome. Several theories of pathogenesis are presented. The authors advocate simple burr hole drainage as the treatment of choice. Significant reaccumulation may occur occasionally.
作者报告了80例创伤性硬膜下积液病例，并讨论了其临床和放射学特征、治疗、手术结果及发病机制。超过50%的病例出现了无脑损伤局灶体征的精神状态改变。在超过40%的“单纯性积液”病例中，临床病程表现为病情稳定但神经功能未完全恢复。腰椎脑脊液常显示出血及蛋白含量升高。39%的病例发现有颅骨骨折，硬膜下积液与脑萎缩、皮质挫伤、硬膜下血肿及硬膜外血肿相关。文中讨论了特征性的血管造影和计算机断层扫描结果，以及手术病理和预后。还提出了几种发病机制理论。作者主张将单纯钻孔引流作为首选治疗方法。偶尔可能会出现大量再积聚。
