Huge Calcified Chronic Subdural Hematoma in the Elderly - Report of a Case

高齡巨大鈣化性慢性硬腦膜下血腫－病例報告

10.6452/KJMS.199704.0272

羅永欽(Joon-Khim Loh)；洪純隆(Shen-Long Howng)

chronic subdural hematoma ； calcification ； outer membrane

The Kaohsiung Journal of Medical Sciences

13卷4期（1997 / 04 / 01）

272 - 276

英文

高齡巨大鈣化性慢性硬腦膜下血腫的病人十分罕見，本文報告一73歲男性病人，其症狀為右側肢體乏力，癲癇而被當腦中風般的治療有8年之久。住院的前一天，因症狀持續惡化，神智不清而入院接受治療。顱骨攝影及腦部電腦斷層檢查證實為一左側大腦由額葉延伸至枕葉之巨大鈣化慢性硬腦膜下血腫。經外科行全摘除術，約有300克暗紅色似黏土狀之血塊被清除出來。而已鈣化之血腫外膜經顯微鏡及電子顯微鏡下檢視竟然發現有許多血管之增生，而紅血球也經由此漏出而使血腫繼續增大。此一發現證實即使是己鈣化之慢性硬腦膜下血腫也有繼續增大的能力，故對於症狀持續惡化之病人宜施行手術清除血腫。

A 73-year-old man who had a huge calcified chronic subdural hematoma reported. He developed progressive right hemiparesis and conscious disturbance. Computerized tomography demonstrated a huge subdural hematoma bordered by a calcified rim. A large osteoplastic craniotomy was performed and revealed approximately 300 grams of paste-like, muddy blood clot. The calcified outer membrane contained proliferating capillaries which was conceiveably contributed to the leakae of blood. It is noteworthy an active vascular proliferation was observed even in the healed tissue with calcification.