慢性硬脑膜下血肿的CT诊断和治疗

报告80例经CT诊断的慢性硬脑膜下血肿，其中低密度血肿39例，等密度23例．混合密度16例，高密度2例。混合密度中有11例具有沉积征象，虽然这一征象仅仅见于一小部分病人，但这一特征说明病人有再出血和预示病情恶化的可能。等密度血肿不易识别，容易漏诊或误诊，增强扫描及血管造影将有助于等密度血肿的确诊。

CT Diagnosis and Treatment of Chronic Subdural Hematoma

Eighty eases of chronic subdural hematoma were diagnosed by CT scan Among them, hypodensity was seen in 39 cases, isodensity in 23 cases, hyperdensity in 2 cases and mixed density in 16 cases. Sedimentation sign could be seen in 11 cases showing mixed density. Though this sign accounted only for a small portion of the series of patients. it might kerald the possibility of secoudarT hleeding and aggravation of clinical condition Misdiagnosis of chronic subdural hematoma by CT may occur when the hematoma is of isodensity. The signs of a midline shift, ventricular compression on obliteration of cortical sulci on the side of hematoma and the history of head injury should alert a clinician to the suspect of the existence of an occult isodense subdural hematoma Preoperative contrast-enhanced computed tomography and angiography may be required for the verification of isodense hematoma. Treatment consisted of a burr-hole drainage of the hematoma in 67 cases. Only one patient required a bone-flap craniotomy to allow removal of the hematoma and outer membrane. Other 12 cases were treated by conservative treatment.