Calcified Chronic Subdural Hematoma - Case Report

鈣化性慢性硬腦膜下血腫－病例報告

楊宏仁(Hung-Zen Yang) ； 曾勝弘(Sheng-Hong Tseng) ； 陳芸(Yun Chen) ； 林瑞明(Swei-Ming Lin) ； 陳金城(Jin-Cherng Chen)

《慈濟醫學雜誌》 16卷4期 (2004/08) Pp. 261-265

https://doi.org/10.6440/TZUCMJ.200408.0261

摘要

慢性硬腦膜下血腫為常見之疾病，然而鈣化性硬腦膜下血腫並不常見，我們報告一例59歲男性患者，住院前一年曾突發左側肢體乏力，經頭部電腦斷層影像檢查，顯示有右側視丘腦出血及右側大片鈣化硬腦膜下血腫。當時並未進行手術治療，患者接受規則藥物及復健治療，病患肌力日漸改善。近來，病患左側肌力退步，且有麻木現象，無法行走，需倚賴輪椅代步。頭部電腦斷層及核磁共振掃描檢查，顯示右側鈣化硬腦膜下血腫併明顯腫塊效應，病患接受開顱完全切除鈣化硬腦膜下血腫，術後恢復良好，很快即可柱杖行走，麻木感亦緩解。經過一年兩個月之追蹤，並無惡化現象，依據文獻回顧，及治療此病人之臨床經驗，我們認為，慢性硬腦膜下血腫之手術治療確實可行，且通常可造成神經功能之改善。

關鍵字

鈣化 ； 鈣化性硬腦膜下血腫 ； 慢性硬腦膜下血腫 ； 外科手術

並列摘要

Chronic subdural hematoma (CSH) is a well-known disease entity; however, calcified chronic subdural hematoma (CCSH) is uncommon. We report on a 59-year-old man who had sudden onset of left hemiplegia one year before admission. Brain CT scan showed right thalamic hemorrhage and one large calcified subdural hemaotma over the right fronto-temporo-parietal area. No surgical intervention was done then. He had a regular rehabilitation program and his muscle power improved gradually. However progressive deterioration in left side muscle power and left hemibody numbness was noted recently. He could not walk and needed to use a wheel chair. Unenhanced computed tomography and magnetic resonance imaging of the brain showed a CSH with calcified capsule over the right fronto-temporo-parietal area and the hematoma had a marked mass effect. He underwent surgery and the CCSH was excised totally. The patient recovered well. He could walk with a quadricane soon after surgery. He is improving after one year and 2 months of follow up. We feel surgical treatment for CCSH is feasible and often results in neurological improvement.

並列關鍵字

Calcification ； calcified chronic subdural hematoma ； chronic subdural hematoma, surgery