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Vol. 1. Issue 6.
Pages 384-390 (January 1990)
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Vol. 1. Issue 6.
Pages 384-390 (January 1990)
Hematoma subdural crónico. Estudio de la expansión cerebral utilizando la inyección espinal de suero fisiológico durante la cirugía
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J.A. Gómez-Moreta, F. Morales, J. Hernández, P. Díaz, A. Maillo
Servicio de Neurocirugía. Hospital Virgen de la Vega. Salamanca
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Resumen

Se estudian 31 pacientes con H.S.C. tratados mediante trépanos e inyección espinal de suero fisiológico, utilizando la técnica descrita por LaLonde y Gardner. La edad media fue de 70 años. La reexpansión cerebral intraoperatoria se mantuvo solamente en nueve ocasiones produciéndose nuevo colapso cerebral en el resto, como se constataba por TAC. Los mejores resultados se obtuvieron en los casos de colección unilateral, edad por debajo de los 51 años y que precisaron menos de 70 cc. de suero fisiológico para conseguir la expansión cerebral durante la intervención.

Tras el tratamiento se obtuvo reexpansión cerebral completa en todos los casos, a los 10 días en nueve colecciones unilaterales, a los 58 días en otras quince y a los 82 días en seis bilaterales. Seis pacientes fueron reintervenidos, cinco de ellos con colección bilateral en el momento del ingreso. Hubo un éxitus. Presentamos las complicaciones del método y se discuten los resultados.

Palabras clave:
Hematoma subdural crónico
colección subdural
tomografía computarizada
expansión cerebral
inyección espinal
Abstract

We prospectively studied 31 consecutive patients with chronic subdural hematomas treated by burr-holes and spinal injection of saline, using the technique first described by LaLonde and Gardner. The mean age was 70 years. Brain reexpansion, observed at operation, was maintained in only nine patients failing to maintain expansion of the cerebral hemispheres in the other cases, as shown by computed tomography. The best results were achieved in unilateral collections, where mean age was below 51 years and who had less than 70ml. of saline injected.

This surgical procedure allowed us to obtain full cerebral reexpansion in all patients, in an average of 10 days in nine unilateral cases, 58 days in 15 unilateral cases, and 82 days in six bilateral hematomas. Six patients needed reoperation, five of whom had bilateral hematomas at admission. There was one death. Intra and postoperative complications are presented, and the results discussed.

Key words:
Chronic subdural hematoma
subdural collection
computed tomography
cerebral expansion
spinal injection

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