28例急性颅脑损伤继发大面积创伤性脑梗死的诊治分析

目的探讨28例大面积创伤性脑梗死的致病原因及预后影响因素。方法对28例脑梗死患者中蛛网膜下腔出血(SAH)部位与预后的关系以及梗死部位与预后的关系分别进行分析。结果预后良好14例(50％)，中残3例(10．7％)，重残2例(7．1％)，植物生存1例(3．6％)，死亡8例(28．6％)。SAH位于脑裂池者11例中有7例死亡(63．6％)，占死亡总人数的87．5％。梗死灶位于双额叶或累及视丘下部者死亡4例(占50％)，颞顶叶累及基底节者死亡4例(占50％)。结论SAH位于脑裂池者预后差，梗死部位位于双额叶或双额叶累及视丘下部者、颞顶叶累及基底节者预后差，

Diagnosis and treatment of 28 patients with extensive traumatic cerebral infarction after acute brain injury

Objective To explore the causes and prognostic factors of extensive traumatic cerebral infarction after brain injury.Methods The relation between the site of subarachnoid hemorrhage(SAH) and prognosis,and the relation between infarction site and prognosis were analyzed.Results Good outcomes were achieved in 14 patients(50%),medium outcomes in 3(10.7%),poor outcomes in 2(7.1%),vegetative status in 1(3.6%)and death in 8(28.6%).Among 11 patients with SAH in the subarachnoid cistern,7(63.6%)died,making up 87.5% of overall mortality.Among the patients with infarction mainly in bilateral frontal lobes or involving hypothalamus,four died(50%).Among those with infarction mainly in temporoparietal lobe and involving the basal ganglia,four died(50%).Conclusion Patients with infarction mainly in bilateral frontal lobes or involving the hypothalamus,or in temporoparietal lobe and involving the basal ganglia,or patients with SAH in the subarachnoid cistern have poor outcomes.