Raftopoulos C, Massager N, Balériaux D, Deleval J, Clarysse S, Brotchi J
Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium.
Neurosurgery. 1996 Jan;38(1):51-9. doi: 10.1097/00006123-199601000-00014.
From 1986 to 1989, 23 adult patients (average age, 70 yr) with idiopathic chronic hydrocephalus received shunts with medium-pressure Pudenz-Schulte valves for suspected normal pressure hydrocephalus. Prospective clinical and computed tomographic monitoring was continued for at least 5 years. We observed the formation of a hypodense subdural collection in each of 10 patients (43%). Those collections that occurred early, i.e., within the first 9 postoperative days, evolved differently from those that occurred late; only early hypodense collections became subdural hematomas (three cases). In one case, a subdural hematoma was already present 9 days after surgery, so that four patients (17%) presented a subdural hematoma within the first 2 postoperative months. Our long-term follow-up revealed three patients (13%) with hypodense subdural collections, which appeared more than 2 months after surgery. None of the collection evolved into a subdural hematoma. Thirteen patients (57%) died between 9 and 68 months (average, 20 mo) after surgery, most often of an ischemic stroke. During the 1st postoperative year, there was improvement in the condition of 22 patients (96%) who had received a ventricular shunt; 21 of these patients (91%) remained improved until death or for at least 5 years.
1986年至1989年期间，23例成年患者（平均年龄70岁）因疑似正常压力脑积水接受了中压Pudenz-Schulte瓣膜分流术。前瞻性临床和计算机断层扫描监测持续至少5年。我们观察到10例患者（43%）均出现了低密度硬膜下积液。早期出现的积液，即术后9天内出现的积液，与晚期出现的积液演变情况不同；只有早期的低密度积液会发展为硬膜下血肿（3例）。有1例患者术后9天就出现了硬膜下血肿，因此有4例患者（17%）在术后2个月内出现了硬膜下血肿。我们的长期随访发现，有3例患者（13%）出现了低密度硬膜下积液，这些积液在术后2个多月出现。这些积液均未发展为硬膜下血肿。13例患者（57%）在术后9至68个月（平均20个月）之间死亡，最常见的死因是缺血性中风。在术后第1年，接受脑室分流术的22例患者（96%）病情有所改善；其中21例患者（91%）直至死亡或至少5年内病情持续改善。
