Advances in diagnosis and treatment of chronic subdural hematoma complicated with subdural empyema after trepanation and drainage
10.3760/cma.j.issn.1001-8050.2019.11.016
- VernacularTitle: 慢性硬膜下血肿钻孔引流术术后并发硬膜下积脓的诊治研究进展
- Author:
Hang XUE
1
;
Weitao ZHANG
1
;
Yiming ZHANG
2
;
Bing YU
3
;
Lin SHI
1
;
Hongfa YANG
1
Author Information
1. Department of Neurosurgery, First Hospital of Jilin University, Changchun 130021, China
2. Department of Neurosurgery, Qilu Hospital of Shandong University, Ji'nan 250012, China
3. Department of Neurosurgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, China
- Publication Type:Review
- Keywords:
Hematoma, subdural, chronic;
Drainage;
Subdural empyema
- From:
Chinese Journal of Trauma
2019;35(11):1051-1056
- CountryChina
- Language:Chinese
-
Abstract:
Most patients with chronic subdural hematoma (CSDH) have a history of craniocerebral trauma. Avulsion of intracranial pontine vein is the main pathogenesis after craniocerebral injury. CSDH drilling and drainage is the most widely used surgical method, with low recurrence and mortality rate. However, the postoperative complication of subdural pyometra is extremely rare, which leads to high mortality and disability rate and thus representing a very challenging disease in trauma surgery. Old age, diabetes mellitus, drainage with foreign body, craniocerebral surgery, open wound, chronic systemic infectious diseases (sinusitis, otitis media, abdominal abscess, lung infection, urinary tract infection), tumor or immune deficiency diseases are all the high risk factors. This paper reviews the pathogenesis, pathogenic bacteria, clinical manifestations, auxiliary examination, treatment and prognosis of subdural empyema after CSDH drilling and drainage in recent years, and provides suggestions for clinical management.
