Fukui S
Department of Neurosurgery, Haibara General Hospital, Shizuoka, Japan.
No To Shinkei. 1993 May;45(5):449-53.
A consecutive series of 76 aged (over 80 years old; 50 male, 26 female) patients with chronic subdural hematoma (CSDH) was studied. They were analyzed about interval form trauma, preoperative grade according to Bender scale, coexisting disease, volume and location of hematoma, surgical procedures, postoperative outcome and complications. Sixty-six% of patients had a history of trauma. Clinical findings at the time of admission were graded according to Bender scale. The majority of patients belonged to grade 2 (41 cases) and grade 3 (23 cases) followed by grade 1 (8 cases) and grade 4 (4 cases). The volume of CSDH was classified into three group; under 79 ml (21 cases), between 80 and 119 ml (28 cases), over 120 ml (27 cases). Almost all of patients were operated by burr hole, irrigation with drainage or Ommaya's reservoir. Six cases needed reoperation. Six cases suffered from infections. Sixty-eight (89%) patients improved at the time of discharge. Surgical procedure is the best choice for CSDH even in extremely aged patients.
对连续的76例年龄在80岁以上(男性50例,女性26例)的慢性硬膜下血肿(CSDH)患者进行了研究。分析了他们受伤后的间隔时间、根据本德量表的术前分级、并存疾病、血肿的体积和位置、手术方式、术后结果及并发症。66%的患者有外伤史。入院时的临床表现根据本德量表进行分级。大多数患者属于2级(41例)和3级(23例),其次是1级(8例)和4级(4例)。CSDH的体积分为三组:79毫升以下(21例)、80至119毫升(28例)、120毫升以上(27例)。几乎所有患者均接受了钻孔、冲洗引流或Ommaya贮器手术。6例需要再次手术。6例发生感染。68例(89%)患者出院时病情好转。即使对于极高龄患者,手术也是治疗CSDH的最佳选择。