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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.54 no.1 São Paulo Mar. 1996

https://doi.org/10.1590/S0004-282X1996000100012 

Hematoma subdural crônico: análise de 35 casos

 

Chronic subdural hematoma: analysis of 35 cases

 

 

João Flavio M. AraújoII; Maria Gracia IafigliolaIII; Roque José BalboI

IDepartamento de Neuro-Psiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas Departamento de Neurologia do Hospital Vera Cruz: Professor Adjunto
IIDepartamento de Neuro-Psiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas Departamento de Neurologia do Hospital Vera Cruz: Neurocirurgião
IIIDepartamento de Neuro-Psiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas Departamento de Neurologia do Hospital Vera Cruz: Médica Residente

 

 


RESUMO

Os autores relatam 35 casos com diagnóstico de hematoma subdural crônico, operados no período de janeiro-1988 a março-1995. A idade dos pacientes variou entre 19 e 80 anos. Foram eles agrupados retrospectivamente segundo a escala de Bender. Quanto ao tratamento cirúrgico, foram empregadas duas técnicas: craniotomia com membranectomia e dupla trepanação com instilação de solução salina na cavidade ocupada pelo hematoma. O índice de mortalidade entre os pacientes submetidos à craniotomia foi 16,6% e nos pacientes submetidos à trepanação foi nulo. Dentre os pacientes que faleceram, 80% encontravam-se em grau III ou IV na escala de Bender. O hematoma subdural crônico apresenta até os dias atuais alguns aspectos controversos, como quanto à sua fisiopatologia e ao tratamento cirúrgico adequado.

Palavras-chaves: hematoma subdural crônico, craniotomia, trepanação.


ABSTRACT

Thirty five patients with chronic subdural hematoma were treated surgically between 1988 and 1995. The patients, aged 19 to 80 years, were graded retrospectively according to the Bender scale. The clots were removed via burr-holes with irrigation of the subdural space to ensure as complete an evacuation of subdural colletion, and craniotomy with membranectomy. The mortality rate was 16.6% with craniotomy and 0% with burr-hole. The patients who died, 80% were in grade III or IV. The pathogenesis and surgical treatment of chronic subdural hematoma has been controversial, and still remains obscure.

Key words:chronic subdural hematoma, craniotomy, burr-hole evacuation.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

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Aceite: 2-setembro-1995.

 

 

Dr. João Flavio de Mattos Araújo - Departamento de Neurologia, Hospital Vera Cruz - Avenida Andrade Neves 402 - 13013-900 Campinas SP - Brasil.

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