目的探讨老年双侧慢性硬膜下血肿(CSDH)的诊断和治疗。方法选取老年双侧CSDH患者45例,均经CT和/或MRI检查确诊,行钻孔引流术。回顾性分析患者的临床资料。结果 45例患者手术后均痊愈,术后半年和1年随访时,GOS评分均为5分。5例患者病程中出现明显颅内积液,经保守处理后好转。4例在第1次手术后3~5个月内出现CSDH复发,均为单侧,经再次手术后血肿消失。结论老年双侧CSDH的主要诊断手段是CT和MRI,钻孔引流是处理的有效方法。 Objective To investigate the diagnosis and treatment of elderly bilateral chronic subdural hematoma (CSDH). Methods Forty-five elderly patients with bilateral CSDH were selected and confirmed by CT and / or MRI. Retrospective analysis of the clinical data of patients. Results All the 45 patients were cured after operation. The GOS score was 5 points after six months and one year follow-up. 5 patients showed obvious intracranial effusion in the course of disease, after conservative treatment improved. In 4 cases, recurrence of CSDH occurred within 3 to 5 months after the first operation, all of which were unilateral. The hematoma disappeared after reoperation. Conclusion The main diagnostic methods of bilateral CSDH in elderly are CT and MRI, and drilling drainage is an effective method for treatment.