CAJ | 학술논문

目的探讨蛛网膜囊肿合并慢性硬膜下血肿的临床特点及治疗方法.方法采用回顾性病例研究方法,对北京天坛医院1997年12月至2009年12月期间收治的11例蛛网膜囊肿合并慢性硬膜下血肿患者进行分析,其中男9例,女2例,年龄7～68岁,平均23.1岁.临床表现为头痛患者10例,面肌抽搐,双眼斜视1例;既往头部明显外伤病史6例,剧烈运动史1例,无外伤史4例.结果 3例患者行保守治疗后症状加重,后改行颅骨钻孔硬膜下血肿引流术;所有9例行颅骨钻孔硬膜下血肿引流术患者中7例术后恢复好,另2例分别于术后第20、40天复发硬膜下血肿,再次行钻孔引流术后恢复可;2例行开颅硬膜下血肿清除合并蛛网膜囊肿切除术,术后痊愈.11例患者术后分别随访10个月至12年10个月,未再复发硬膜下血肿,均能正常学习、工作和生活,行KPS评分均在80分以上.结论蛛网膜囊肿可能是导致慢性硬膜下血肿发生的一个危险因素,尤其在年轻患者,颅脑损伤是引起蛛网膜囊肿并发硬膜下血肿的一个常见诱因,临床上多表现为头痛,治疗首选颅骨钻孔硬膜下血肿引流术.
목적 탐토주망막낭종합병만성경막하혈종적림상특점급치료방법.방법 채용회고성병례연구방법,대북경천단의원1997년12월지2009년12월기간수치적11례주망막낭종합병만성경막하혈종환자진행분석,기중남9례,녀2례,년령7～68세,평균23.1세.림상표현위두통환자10례,면기추휵,쌍안사시1례;기왕두부명현외상병사6례,극렬운동사1례,무외상사4례.결과 3례환자행보수치료후증상가중,후개행로골찬공경막하혈종인류술;소유9례행로골찬공경막하혈종인류술환자중7례술후회복호,령2례분별우술후제20、40천복발경막하혈종,재차행찬공인류술후회복가;2례행개로경막하혈종청제합병주망막낭종절제술,술후전유.11례환자술후분별수방10개월지12년10개월,미재복발경막하혈종,균능정상학습、공작화생활,행KPS평분균재80분이상.결론 주망막낭종가능시도치만성경막하혈종발생적일개위험인소,우기재년경환자,로뇌손상시인기주망막낭종병발경막하혈종적일개상견유인,림상상다표현위두통,치료수선로골찬공경막하혈종인류술.
Objective To explore the clinical characteristics and treatment strategy of arachnoid cyst associated with chronic subdural hematoma. Methods A retrospective analysis was made for 11 cases of arachnoid cyst associated with chronic subdural hematoma at our hospital from December 1999 to December 2009. There were 9 males and 2 females with a mean age of 23. 1 years old (range:7 -68). Their clinical characteristics were summarized. The symptoms included headache ( n = 10 ) and facial muscle twitching & eye squinting ( n = 1 ). History of previous head injury were found in 6 cases, strenuous exercise in 1 case and no history of injury in 4 cases. Results The clinical symptoms of 3 patients worsened after a conservative treatment and underwent a burred-hole procedure with drainage of hematoma. And 7/9 patients undergoing a burred-hole procedure with drainage of hematoma had a full recovery. But 2/9 had recurrent subdural hematoma at Days 20 and 40 pest-operation respectively and underwent the same procedure. Another 2 cases underwent craniotomy to remove subdural hematoma and arachnoid cyst and had stayed free of any symptom since then. All patients were followed up for 10 - 154 months after discharge. And none had recurrent subdural hematoma. All could study, work or live normally with a KPS ( Karnofsky performance scale) score of 80 or more. Conclusion Arachnoid cysts is a possible risk factor for subdural hematoma,especially in young adults. Chronic subdural hematoma generally develops within 1 - 3 months after head injury. And a common clinical presentation is headache. A burred-hole procedure with drainage of hematoma is adequate as the first-line treatment for arachnoid cyst associated with chronic subclural hematoma.