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慢性硬膜下血肿(CSDH)诊断很困难,误诊率很高。本文收集我院1989年1月至1991年6月经CT 及手术证实的 CSDH26例。临床资料一般资料本组26例,占同期 CT 及手术证实的 CSDH 的39.39%(26/66)。其中男20例,女6例,年龄3～69岁,平均60.3岁,50岁以上者21例,占80.77%。有明确外伤史19例,但 CT 检查前问出者只2例,无外伤史7例;外伤至发病时间最短14天,最长8个月。发病至就诊或 CT 检查时间最短5天,最长60天,平均28天。临床表现头晕头痛20例,恶心、呕吐17例,肢体乏力、麻木或偏瘫16例,四肢震颤3例,神志不清8例,耳鸣复视3例,精神异常1例,眼球外展不全1例,眼底视乳头水肿8例,巴氏征阳性2例;血压升高7例,平均舒张压为14.5kPa,余19例血压正常;腰穿18例,脑压正常4例,脑压升高(1.96～3.53kPa)14例,脑脊液黄变或有皱折红细胞者4例,脑脊液镜检及生化正常14例。临床误诊为脑出
Chronic subdural hematoma (CSDH) diagnosis is very difficult, high misdiagnosis rate. This collection of our hospital from January 1989 to June 1991 by CT and surgery confirmed CSDH26 cases. Clinical data General information The group of 26 cases, accounting for the same period of CT and surgical confirmed CSDH 39.39% (26/66). Including 20 males and 6 females, aged 3 to 69 years, an average of 60.3 years old, 21 patients over the age of 50, accounting for 80.77%. A clear history of trauma in 19 cases, but before the CT examination asked only two cases, no history of trauma in seven cases; trauma to the onset of the shortest 14 days, up to 8 months. The onset to treatment or CT examination of the shortest 5 days, up to 60 days, an average of 28 days. Clinical manifestations of dizziness and headache in 20 cases, nausea and vomiting in 17 cases, limb weakness, numbness or hemiplegia in 16 cases, tremor in limbs in 3 cases, 8 cases of delirium, tinnitus diplopia in 3 cases, 1 case of abnormal vision, eye outreach in 1 case , Papilledema of the fundus in 8 cases and Papanicola streak positive in 2 cases. The blood pressure increased in 7 cases with an average diastolic pressure of 14.5 kPa and the remaining 19 cases of normal blood pressure; 18 cases of lumbar puncture, 4 cases of normal brain pressure, 3.53kPa), 14 cases of cerebrospinal fluid yellow or erythrocyte fold in 4 cases, cerebrospinal fluid microscopy and biochemical normal in 14 cases. Clinical misdiagnosed as brain out