[Clinical analysis of 10 patients of chronic subdural hematoma associated with arachnoid cyst]

Zhonghua Yi Xue Za Zhi. 2017 May 23;97(19):1502-1504. doi: 10.3760/cma.j.issn.0376-2491.2017.19.015.
[Article in Chinese]

Abstract

Objective: To investigate the clinical characteristics, pathogenesis and surgical strategy for the chronic subdural hematoma associated with arachnoid cyst (AC). Method: Ten patients of chronic subdural hematoma associated with AC were retrospectively enrolled from the Neurosurgery Department of Tianjin Medical University General Hospital from January 2012 to September 2015, with a mean age of 27.5±5.6 years (range, 18-37 years). All patients simply performed a burr hole drainage of hematoma and left the AC intact, then followed up for 12 to 18 months after discharge respectively. Results: In this study, the AC in 8 of 10 cases occurs in the middle cranial fossa, and the other 2 cases root in the cerebral hemisphere.The AC of 10 patients all locate near the hematoma cavity.Nine patients had a full recovery, and only one patient had a recurrent subdural hematoma with a secondary operation, then recovery in 3 months postoperation.All patients lived completely free of neurological symptom and showed no recurrence in the follow-up period with a Barthel index more than 90. Conclusion: Simply burr hole drainage of hematoma and leave intact AC achieves satisfied outcome and provides a reliable therapy strategy for chronic subdural hematoma associated with arachnoid cyst.

目的: 探讨蛛网膜囊肿(AC)合并慢性硬膜下血肿(CSDH)患者的临床特点及治疗策略。 方法: 回顾性分析2012年1月至2015年9月天津医科大学总医院神经外科收治的AC合并CSDH患者10例,年龄18~37岁,平均(27.5±5.6)岁,所有患者均采用颅骨钻孔硬膜下血肿引流术,不处理AC的手术策略进行治疗。术后随访12~18个月。 结果: 10例中AC位于单侧中颅窝底8例,位于大脑半球表面2例,10例的AC均与CSDH临近。9例术后恢复良好,1例术后复发再次行硬膜下血肿钻孔引流术,术后恢复良好。所有患者术后随访中临床症状均明显改善,术后6个月Barthel指数均在90分以上。 结论: 颅骨钻孔硬膜下血肿引流、不处理AC的治疗策略对于AC合并CSDH患者疗效可靠。.

Keywords: Arachnoid cysts; Chronic subdural hematoma; Surgical procedures.

MeSH terms

  • Adolescent
  • Adult
  • Arachnoid Cysts / complications*
  • Arachnoid Cysts / surgery
  • Drainage / methods*
  • Female
  • Hematoma, Subdural, Chronic / complications*
  • Hematoma, Subdural, Chronic / surgery
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Postoperative Period
  • Young Adult