慢性硬膜下血腫之非手術療法－四病例報告

慢性硬膜下血腫為硬膜與蜘蛛網膜間的明顯積液，由一層膜所包圍。其引起的原因可分為創傷性和非創傷性兩種。未經治療的慢性硬膜下血腫病人多因腦部無法代償或合併其他感染導致死亡，故其治療多以手術為主。然亦有少數病人可以內科療法使之自然吸收，如臥床休息、使用類固醇，或高滲療法等。過去兩年內，本院神經內科有四例慢性硬膜下血腫病人，年齡均為七十歲以上，其中三例有受傷史，一例原因不明，經非手術療法（三例臥床休息，一例高滲療法）後，腦部電腦斷層顯示血腫完全吸收或縮小，臨床症狀改善。故對於年老者或其他不適於手術的病人，內科治療慢性硬膜下血腫是可行的。

關鍵字

慢性硬膜下血腫；非手術

並列摘要

Chronic subdural hematomas are clearly delineated fluid collections located between the dura mater and the arachnoid. Long-standing subdural hematomas are enclosed within a hematoma capsule. The origin of blood accumulation within the subdural space is traumatic or spontaneous. Untreated chronic subdural hematoma leads to death in most instances, either by hematoma induced cerebral decompensation or as a result of concomitant infections and worsening of the patient's general condition. Its operative indication is almost universally accepted. The fact that spontaneous resolution of chronic subdural hematoma has been observed has encouraged some clinicians to treat patients with bed rest, corticosteroids, or osmotherapy. In the past two years, our neurological section had four cases of chronic subdural hematoma whose ages were all above seventy years old. They received nonsurgical treatment (three cases with bed rest and one case with osmotherapy) and got improvement or completely resolution of the subdural hematoma. In the debilitated elderly patient at greatest anesthetic risk who has only a small subdural hematom and minimal neurologic signs, medical management may be appropriate and beneficial.

並列關鍵字

Chronic subdural hematoma ； nonsurgical

國際替代計量

慢性硬膜下血腫之非手術療法－四病例報告

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