Postoperative brain tissue recovery in patients with bilateral chronic subdural hematomas
10.3760/cma.j.issn.1671-8925.2017.12.017
- VernacularTitle:双侧慢性硬膜下血肿钻孔引流术后脑组织回复情况研究
- Author:
Haichun LI
1
;
Xiangyu MENG
;
Jianjun YANG
;
Dongming SI
;
Li JIAN
;
Long XU
;
Lei WANG
;
Weiming LIU
Author Information
1. 河南中医药大学第一附属医院神经外科
- Keywords:
Bilateral chronic subdural hematoma;
Drilling and drainage;
Brain tissue recovery
- From:
Chinese Journal of Neuromedicine
2017;16(12):1275-1279
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the brain tissue recovery in patients with bilateral chronic subdural hematomas after drilling and drainage treatments. Methods The clinical data of 143 patients with bilateral chronic subdural hematoma performed drilling and drainage in our hospital from January 2011 to December 2016 were collected, including gender, age, the longest and widest diameters of the skull and the longest diameter of the initial hematoma, the widest diameter of the initial hematoma, the widest diameter of the postoperative hematoma, and other clinical information. The postoperative absorption of hematoma and recovery of brain tissues were analyzed. Results In these 143 BCSDH patients, 119 were male and 24 were male; the mean age of these patients was (67.7 ±1.1) years (21-92 years old), and the mean age of male patients was (67.2 ±1.2) years and the mean age of female patients was (70.2±2.5) years. The longest diameters of the skull was 134.8 mm-177.8 mm (averaged 155.5 mm± 0.7 mm) and the widest diameters of the skull was 113.5 mm-147.0 mm (averaged 131.7 mm±0.5 mm). The longest diameters of the left and right initial hematomas were (113.4±2.5) mm and (117.6±2.1) mm,and the widest diameters of the left and right initial hematomas were (15.8±0.5) mm and (17.2±0.8) mm. There was no significant difference in the recovery rate of brain tissues between patients with different gender, age or lesion sides (P<0.05). The recovery rate of brain tissues was positively correlated with the longest and widest diameters of initial hematomas (r=0.143, P=0.018; r=0.181, P=0.002). A total of 58 patients (40.6%) presented a single-side distance<10 mm from the brain tissue to the inner edge of the skull within one week after surgery, and a total of 48 patients (33.6%) showed both sides brain recovery to<10 mm. Conclusions Drilling and drainage are the first line treatment for patients with bilateral chronic subdural hematoma and contribute to the re-location of brain tissues. The rate of brain tissue recovery is positively correlated with the size of primary hematoma.