Nomura S, Orita T, Tsurutani T, Izumihara A
Department of Neurosurgery, Shutoh General Hospital, Yamaguchi, Japan.
Nihon Geka Hokan. 1996 Jan 1;65(1):30-5.
Three surgical cases of subacute subdural hematomas are reported considering the pathophysiology. All patients had head traumas and complained the worsenings of the headaches 7-14 days after the head traumas. Serial computed tomography scan (CT) revealed the expansions of the subdural hematomas with the change of the density from high to mixed. The surgical findings of the hematomas showed blood clots and liquid covered with thin membranes. Morinaga et al. suggested the etiology of the subacute subdural hematoma that the influx of cerebrospinal fluid (CSF) to the hematoma cavity through the teared arachnoid. Our macroscopic findings of the hematomas which had the CSFlike liquid supported this estimation. We suggest that subacute subdural hematoma should be differed from chronic subdural hematoma because it may have the proper mechanisms of the development. Mild acute subdural hematomas should be observed carefully because they may develop to be subacute subdural hematomas between 1 and 3 weeks after the onset.
本文结合病理生理学报告了3例亚急性硬膜下血肿的手术病例。所有患者均有头部外伤史,并在受伤7 - 14天后出现头痛加重症状。连续计算机断层扫描(CT)显示硬膜下血肿扩大,密度从高变混。血肿的手术所见为血凝块及覆有薄膜的液体。盛永等人提出亚急性硬膜下血肿的病因是脑脊液(CSF)通过撕裂的蛛网膜流入血肿腔。我们对含有脑脊液样液体的血肿的大体观察结果支持了这一推测。我们认为亚急性硬膜下血肿应与慢性硬膜下血肿相区分,因为其可能有独特的发展机制。轻度急性硬膜下血肿应密切观察,因为它们可能在发病后1至3周发展为亚急性硬膜下血肿。