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老年人慢性硬脑膜下血肿(CSH)常由于没有明确外伤史,且临床表现不典型,容易误诊;本文报道14例临床误诊病例,并就误诊教训作初步分析。临床资料本组CSH14例,男13例,女1例,其中60～69岁7例,70～79岁7例。入院时均无明确外伤史记载,临床表现主要有偏瘫、头痛、精神障碍、失语和痴呆。本组14例中,临床误诊为脑血栓9例,颅内肿瘤3例,精神分裂症和病毒性脑炎各1例。全部病例最后均经CT检查确诊,其中双侧血肿2例,单侧血肿12例,CT测量血肿量均在80ml以上,最多达150ml,根据CT密度可分为低密度血肿7例,混合密度血肿5例,等密度和高密度血肿各1例。10例手术结果显示,低密度、等密度血肿腔内无明显血凝块或机化血块,而混合密度或高密度血肿腔内除有暗
Chronic subdural hematoma (CSH) in elderly patients is often misdiagnosed because there is no definite history of trauma and the clinical manifestations are not typical. In this paper, 14 cases of misdiagnosis were reported and preliminary analysis was made on the misdiagnosis and lessons learned. Clinical data CSH14 cases of this group, 13 males and 1 females, of which 60 to 69 years in 7 cases, 70 to 79 years in 7 cases. No clear history of trauma when admitted to the hospital, the main clinical manifestations are hemiplegia, headache, mental disorders, aphasia and dementia. The group of 14 cases, clinically misdiagnosed as cerebral thrombosis in 9 cases, 3 cases of intracranial tumors, schizophrenia and viral encephalitis in 1 case. All cases were finally confirmed by CT examination, including 2 cases of bilateral hematoma, unilateral hematoma in 12 cases, CT measurements of hematoma volume were more than 80ml, up to 150ml, according to CT density can be divided into low density hematoma in 7 cases, mixed density hematoma 5 cases, 1 case of equal density and high density hematoma. 10 cases of surgical results showed that low density, isodense hematoma cavity no obvious blood clots or machine blood clots, and mixed density or high density hematoma in the cavity except dark