慢性硬膜下血肿合并急性脑梗塞

目的 探讨慢性硬膜下血肿合并急性脑梗塞的病因、预防与诊断治疗。方法 总结慢性硬膜下血肿合并急性脑梗塞22例，结合献分析。结果 慢性硬膜下血肿合并同侧大面积脑梗塞3例，基底节区梗塞11例，其他脑梗塞8例，其中慢性硬膜下血肿术后脑梗塞12例。结论 血容量不足、凝血机制障碍、脑灌注压降低、血管痉挛、脑动脉硬化与心脏疾病是慢性硬膜下血肿合并急性脑梗塞的原因。血肿钻孔引流、纠正血容量、扩容、解痉、脱水、降颅压、神经保护和抗血小板聚集是其有效治疗手段。

Chronic subdural hematoma complicated with acute cerebral infarction

Objective To study the pathogenesis, prevention, diagnosis and management of chronic subdural hematoma complicated with acute cerebral infarction. Methods The data of 22 cases of chronic subdural hematoma with acute cerebral infarction were summarized and analyzed in integration with literature review. Results Our investigation showed that chronic subdural hematoma was complicated with ipsilateral diffuse cerebral infarction in 3 patients, basal ganglia infarction in 11, and other cerebral infarction in 8 simultaneously. Among them, postoperative infarction occurred in 12. Conclusion Hypovolemia, disturbance of blood coagulation, decrease of cerebral blood irrigation pressure, dysfunction of cerebral flow regulation, vasospasm, cerebral angiosclerosis and cardiopathy are the major causes of chronic subdural hematoma complicated with acute cerebral infarction. The effective therapies for the chronic subdural hematoma with acute cerebral infarction include draining the hematoma, correcting hypovolemia, expanding plasma volume, hemodiluting, applying vasospasmolytic and calcium channel blockers, controlling cerebral edema, reducing the intracranial pressure, undertaking neuro-protection and plalelet antiaggregants.