晚期外伤性小脑幕裂孔下疝的CT表现与临床意义

目的:提高晚期外伤性小脑幕裂孔下疝的影像学认识。方法:对临床上出现双瞳孔散大的103例重型颅脑损伤病例进行回顾性分析。第四脑室按狭窄程度分为闭塞、严重狭窄、轻度狭窄三组进行分析。结果:103例均有第四脑室闭塞或狭窄。其中第四脑室闭塞62例,重度狭窄28例,轻度狭窄13例;死亡人数分别为56例(90.32%)、20例(71.43%)、5例(38.46%)。三组病例的死亡率统计学比较差异有显著性(χ2=18.40,P<0.01)。中脑和脑桥有明显变形、移位、旋转或边界消失。脑桥小脑角池一侧或双侧闭塞。结论:第四脑室闭塞或狭窄是诊断晚期小脑幕裂孔下疝的重要征象。第四脑室狭窄程度与患者死亡率有统计学相关性。

CT Imaging of Traumatic Terminal Transtentorial Hernia And Clinical Values

Objective To improve the diagnosis of terminal Transtentorial Hernia.Methods 103 serious brain injure by diagnosed terminal transtentorial hernia in clinic were retrospective analysed.Hourth ventricle changes were divided into 3 groups(occlusion、serious stenosis、mild stenosis),and were statistical analysed.Results fourth ventricleocclusion or stenosis were seen in all cases.Of 103 cases,62 cases showed fourth ventricle occlusion, 28 cases showed serious stenosis,13 cases showed mild stenosis.The dead cases of each groups were 56 (90.32%),20(71.43%),5(38.46%) respectively.Pons and mesencephal were showedserious distortion and displacement,or rotation, or edge disappearance. One or both sides pontocerebellar cisterna showed occlusion.Conclusion Occlusion or stenosis of Fourth ventricle are the important reliable evidence in diagnosis of terminal transtentorial hernia. There are significant correlation between the degrees of fourth stenosis and death rate.