[A study of acute subdural hematoma developing into hematoma with capsule formation].
[A study of acute subdural hematoma developing into hematoma with capsule formation].
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急性硬膜下血肿发展为包膜血肿的研究[J].
DOI：
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发表时间：
1998
期刊：
影响因子：
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通讯作者：
Y. S. Park
中科院分区：
文献类型：
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作者：
Y. Okumura;T. Shimomura;Y. S. Park
在某些情况下，保守治疗的急性硬膜下血肿（ASDH）不会自然消失，并进展为慢性硬膜下血肿样血肿（CSDH）（血肿伴包膜形成）。本研究的目的是确定可用于预测这种不利的过程中，在早期阶段的病变发生后的因素。在过去的13年中，96例轻度保守治疗的ASDH（不包括哺乳婴儿）中有10例进展为CSDH，这10例患者表现出以下背景特征。男7例，女3例，平均年龄63.1岁。其中5例患者有饮酒史，各1例患者有脑梗死、脑出血和VP分流术史。在ASDH时的急性期计算机断层扫描（CT）显示，在所有10例病例中，血肿中有一个低密度区的扩张型病变，血肿扩展到纵裂。观察到血肿在急性期发生一过性自然收缩。进展为CSDH的时间平均为病变发生后20.5天，其治愈是可能的钻孔。考虑到这些结果，可以推测，当在病变急性期给予保守治疗时，具有以下特征的ASDH患者在亚急性期和慢性期进展为CSDH的风险较高：（1）老年，（2）指示脑萎缩的病史，（3）急性期CT上ASDH的扩展型图像，和（4）急性期CT显示血肿中有脑脊液混合。
There are some cases in which conservatively treated acute subdural hematoma (ASDH) does not disappear naturally and progresses to chronic subdural hematoma-like hematoma (CSDH) (hematoma with capsule formation). The objective of the present study was to identify factors which can be used to predict this unfavorable course during the early phase after the onset of the lesion. During the past 13 years, 10 of 96 cases of mild, conservatively treated ASDH (excluding suckling infants) progressed to CSDH, and those 10 patients showed the following background characteristics. There were 7 males and 3 females, and the mean age was 63.1 years. Five of the patients had a history of alcohol consumption, and one case each had a history of cerebral infarction, cerebral hemorrhage and a VP shunt. Acute-phase computerized tomography (CT) at the time of ASDH showed, in all 10 cases, an expansive-type lesion with a low density area in the hematoma, with expansion of the hematoma into the interhemispheric fissure. The hematoma was observed to undergo transient natural shrinkage in the acute phase. The period for progression to CSDH was indicated to be a mean of 20.5 days after the onset of the lesion, and its cure was possible with trepanation. In consideration of these results, it was surmised that ASDH patients with the following characteristics have a high risk of progression to CSDH during the subacute and chronic phases when conservative therapy is administered during the acute phase of the lesion: (1) old age, (2) a history indicative of brain atrophy, (3) an expansive-type image of ASDH on acute-phase CT, and (4) acute-phase CT indicative of cerebrospinal fluid mixing in the hematoma.