机构:[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[2]Beijing Neurosurgical Institute, Capital Medical University, Beijing研究所北京市神经外科研究所首都医科大学附属天坛医院[3]China National Clinical Research Center for Neurological Diseases, Beijing[4]Neurological Center, Ningxia People’s Hospital, Ningxia, China
OBJECTIVE: To investigate the clinical characteristics, treatment, and outcomes of chronic subdural hematomas (CSDH) in young patients. METHODS: We retrospectively reviewed young patients under 40 years of age who received diagnoses of and were surgically treated for CSDH between August 2011 and May 2017. Clinical data, computed tomographic findings, surgical outcomes, and recurrencewere collected for further analysis. RESULTS: A total of 101 patients (92 male; 91.1%) were analyzed. Ages ranged from 1 to 40 years (27.3 +/- 10.5), and 59 (58.4%) patients had a history of recent head trauma. The most frequent symptoms were headache (86.1%) and dizziness (26.7%). A total of 60 (59.4%) patients had arachnoid cyst (AC), and 8 (7.9%) patients had ventriculoperitoneal (V-P) shunt. After burr hole drainage craniotomy, all patients experienced good outcomes, and 1 patient experienced recurrence requiring reoperation. Sixty-eight patients with AC/V-P shunts had a higher incidence of head trauma (P = 0.014), younger age at onset P < 0.001), and lower incidence of dizziness (P = 0.013) than did those without AC/V-P shunts. Surgical recurrence rates and outcomes did not differ significantly between patients with and without AC/V-P shunts. CONCLUSIONS: Headache is the most common symptom, and AC/V-P shunts are risk factors of CSDH in young patients. AC/V-P shunt-associated CSDH is associated with younger morbidity. Head trauma is a risk factor for AC/V-P shunt-associated CSDH, but is not significance in patients without AC/V-P shunts. Catheter drainage through a burr hole may be the first-choice surgical procedure in treatment of CSDH in young patients, including AC/V-P shunt-associated CSDH.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81502150]; Beijing Outstanding Talent Training Project [2015000021469G222]; National Key Technology Research and Development Program of the Ministry of Science and Technology of ChinaNational Key Technology R&D Program [2014BAI04B01, 2015BAI12B04, 2013BAI09B03]; NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [AR064874, AR068950]
第一作者机构:[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing[2]Beijing Neurosurgical Institute, Capital Medical University, Beijing[3]China National Clinical Research Center for Neurological Diseases, Beijing
通讯作者:
通讯机构:[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing[3]China National Clinical Research Center for Neurological Diseases, Beijing[4]Neurological Center, Ningxia People’s Hospital, Ningxia, China
推荐引用方式(GB/T 7714):
Ou Yunwei,Dong Jinqian,Wu Liang,et al.The Clinical Characteristics, Treatment, and Outcomes of Chronic Subdural Hematoma in Young Patients[J].WORLD NEUROSURGERY.2019,125:E1241-E1246.doi:10.1016/j.wneu.2019.02.017.
APA:
Ou, Yunwei,Dong, Jinqian,Wu, Liang,Xu, Long,Wang, Lei...&Liu, Weiming.(2019).The Clinical Characteristics, Treatment, and Outcomes of Chronic Subdural Hematoma in Young Patients.WORLD NEUROSURGERY,125,
MLA:
Ou, Yunwei,et al."The Clinical Characteristics, Treatment, and Outcomes of Chronic Subdural Hematoma in Young Patients".WORLD NEUROSURGERY 125.(2019):E1241-E1246