Se presentan dos grupos de pacientes con hematoma subdural crónico (H.S.C.) que suman 64 casos, tratados mediante evacuación por trépanos seguida de expansión cerebral activa en el primero de ellos y drenaje contínuo en el segundo. El estudio demuestra que el último método disminuye la morbilidad inherente a la cirugía, confirmando al mismo tiempo que la mortalidad depende fundamentalmente de la situación clínica preoperatoria y no de la técnica utilizada. El seguimiento periódico de todos los casos, valorando los datos clínicos y la exploración TAC, confirma también que la reexpansión cerebral está en relación inversa a la edad y al grado neurológico preoperatorio, siendo menos importantes la presión existente en la cavidad subdural y la modalidad del tratamiento quirúrgico utilizado.
The authors analyze a series of 64 patients with chronic subdural hematoma who were classified into two groups on the basis of the surgical treatment: burr-hole evacuation followed by spinal injection of saline solution, or burr-hole evacuation followed by drainage of the subdural cavity. This prospective study shows that patients operated by the last procedure had less postoperative complications and confirms that mortality is mainly related to the patient's ncurological condition but not to the type of surgical thechnique employed. Postoperative C.T. controls, showed that brain reexpansion is inversely related to the patient's age an neurological grade, and poorly infIuenced by intracavitary pressure or type of surgery.
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