脑外伤合并颈椎损伤的诊断讨论

目的探讨诊断颅脑外伤合并颈椎和颈髓损伤的方法。方法回顾2001年8月至2010年11月我科收治颅脑外伤合并颈椎和颈髓损伤患者32例的受伤机制,临床表现和进行影像学检查情况。结果该组有17例患者首诊时漏诊颈椎和颈髓损伤。结论颅脑外伤合并的颈椎和颈髓损伤易被漏诊。在接诊颅脑外伤患者时应警惕是否合并颈椎和颈髓的损伤,详细询问病史和查体。对疑有颈椎和颈髓损伤而没有意识障碍的患者应尽早予以颈部有效制动,对于有意识障碍的患者,建议常规行颈椎正侧位x线片检查及寰枢椎CT检查。对怀疑有颈髓损伤的惠者应行MRI检查。

Diagnosis of Cervical Spine Injury with Head Injury

Objective To explore the diagnosis of cervical spine injury with head injury. Methods The mjury mechanisms, clinical features and radiological examinations of 32 patients with cervical spine injury and cervical cord injury with head injury, who were admitted in our department between July 2001 and March 2010, were studied retrospectively. Results The diagnosis of cervical spine injury or cervic cord injury was missed in 17 patients in initial diagnosis. Conclusion The diagnosis of cervical spine injury is often missed in patients with head injury. Careful history taking and physical examinatiomust be done in every patient with head injury. Patients who are unconscioushould be given X-rays examination in PA view, lateral view and CT scans of craniocervical junction routinely.Patients who are suspected have cervical cord injury should be given MRI examination.