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目的 探讨慢性硬膜下血肿合并急性脑梗塞的病因、预防与诊断治疗。方法 总结慢性硬膜下血肿合并急性脑梗塞22例,结合文献分析。结果 慢性硬膜下血肿合并同侧大面积脑梗塞3例,基底节区梗塞11例,其他脑梗塞8例,其中慢性硬膜下血肿术后脑梗塞12例。结论 血容量不足、凝血机制障碍、脑灌注压降低、血管痉挛、脑动脉硬化与心脏疾病是慢性硬膜下血肿合并急性脑梗塞的原因。血肿钻孔引流、纠正血容量、扩容、解痉、脱水、降颅压、神经保护和抗血小板聚集是其有效治疗手段。
Objective To investigate the etiology, prevention and diagnosis and treatment of chronic subdural hematoma complicated with acute cerebral infarction. Methods 22 cases of chronic subdural hematoma complicated with acute cerebral infarction were summarized and analyzed by literature. Results There were 3 cases of chronic subdural hematoma complicated with ipsilateral large-area cerebral infarction, 11 cases of basal ganglia infarction and 8 cases of other cerebral infarction. Among them, 12 cases had cerebral infarction after chronic subdural hematoma. Conclusions Insufficient blood volume, clotting mechanism disorders, decreased cerebral perfusion pressure, vasospasm, cerebral arteriosclerosis and heart disease are the causes of chronic subdural hematoma complicated with acute cerebral infarction. Hematoma drilling drainage, correct blood volume, dilatation, antispasmodic, dehydration, reducing intracranial pressure, neuroprotection and anti-platelet aggregation is its effective treatment.