老年人外伤性硬膜下积液的CT诊断（附52例分析）  

CT diagnosis and differential diagnosis of traumatic subdural effusion in elderly patients： a report of 52 cases

作　　者：许品富 卢赠华[2] 

机构地区：[1]福建省平潭县医院放射科,350400 [2]福建医科大学附属协和医院MR室,福州350001

出　　处：《中华神经医学杂志》2010年第11期1154-1157,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨老年人外伤性硬膜下积液（TSE）的CT诊断,以及与老年性脑萎缩的鉴别要点.方法 福建省平潭县医院外科自2008年3月至2010年3月共收治60岁以上的老年TSE患者52例,回顾性分析患者的临床资料和CT表现,并与同期40例老年性脑萎缩患者的CT征象进行比较.结果 本组患者TSE共91处,其中发生于颞额部31例（34.1%）,额部30例（33%）;合并老年性脑萎缩34例;首次CT检查发现TSE者32例,首次CT检查阴性而复查发现TSE者20例.短期内复查CT发现积液量增多32例,TSE患者中具有局部脑回变平、脑沟变浅等占位表现者30例,具有＂蛛网膜内移征＂者9例,而老年性脑萎缩患者CT检查均无上述表现.结论 老年人TSE好发于颞、额部,与老年性脑萎缩的鉴别要点为脑外间隙改变的部位与范围、局部脑回变平脑沟变浅等占位征象、＂蛛网膜内移征＂、短期CT复查时积液量的变化.Objective To investigate how to diagnosis traumatic subdural effusion （TSE） and differentiate it with senile encephalatrophy in aged people by CT scan. Methods Fifty-two aged patients with TSE and 40 aged patients with encephalatrophy, admitted to our hospital from March 2008 to March 2010, were chosen in the study. Their clinical data and CT manifestations were retrospectively analyzed and compared. Results Fifty-two patients with TSE had 91 sites of the lesion, including 31 lesions located in temporal-frontal lobe and 30 lesions in frontal lobe. Among the 52 patients, 34 were also noted as having encephalatrophy. First-time CT demonstrated 32 patients with TSE, and the second-time CT on the left patients showed 20 having TSE too. Among the 52 patients, increasing amount of fluid in a short term was noted in 32 patients; local widened gyri with a flattened surface and narrowed sulci was presented in 30; ＂compressed arachnoid sign＂ was found in 9. CT results demonstrated that no above-mentioned manifestations were presented in patients with encephalatrophy.Conclusion For aged person, TSE is usually located in the temporal and frontal lobe, and should be differentiated with senile encephalatrophy. The key-points for differentiation include the location and the extent of changes of extra-cerebral space, the space-occupying signs as local flattened gyri and narrowed sulci, the appearing of ＂compressed arachnoid sign＂ and the changes of effusion in a short-term review.

关 键 词：颅脑损伤 硬膜下积液 老年人 

分 类 号：R686[医药卫生—骨科学]