TU Ming,ZHANG Zibin,WU Jinsen, et al. The relationship between different surgical regimens and the prognosis of patients with organized chronic subdural hematoma[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2017, 47(12): 906-909,913.
Abstract：Objective: To explore the relationship between different surgical regimens and the prognosis of patients with organized chronic subdural hematoma (OCSDH), and to evaluate contributing factors influencing surgical outcome. Methods: Clinical data of patients with OCSDH in the First Affiliated Hospital of Wenzhou Medical University from April 2011 to November 2013 were collected retrospectively. A total of 4 patients with OCSDH were identified and divided into 2 groups according to the two different operation methods, burr-hole drainage followed by craniotomy for hematoma removal, or direct-craniotomy for hematoma removal. Comparison between the two groups in terms of their preoperative and postoperative consciousness, GCS, physical examination, imaging, and the different surgical methods were compared. The relevance of membranectomy of OCSDH envelope firmly attached to the cerebral cortex, to prognosis of disease was also analyzed. Results: Patients who underwent membranectomy of OCSDH envelope had poor prognosis after surgery, one death and the other showed upward gaze and motor aphasia; the group with no resection of the envelope during surgery had better prognosis and neurological function. Conclusion: For OCSDH with envelope attached to cerebral cortex, we recommend the use of craniotomy for hematoma removal, without membranectomy of OCSDH envelope firmly attached to the cerebral cortex, since that results in to the better prognosis.
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