外伤性弥漫性脑萎缩的临床特征

目的:探讨外伤性弥漫性脑萎缩的临床特征及其形成机制。方法:外伤性弥漫性脑萎缩患者26例,其中硬膜下血肿19例,广泛脑挫裂伤4例,弥漫性轴索损伤(DAI)3例,合并有蛛网膜下腔出血(SAH)17例,于入院时、伤后3d、1周、3周及1月余行头颅CT检查。结果:本文26例患者在CT复查中均表现为双侧大脑半球不同程度的脑室、脑池、脑沟扩大增宽,脑回变窄,其两侧脑室额角间夹角≥140°,尾状核指数为16.8%-32.1%,(平均24.2%)。结论:本文外伤性弥漫性脑萎缩的主要病因,可能与弥漫性神经元和轴突的原发损伤以及外伤后脑缺血性损害有关。

Clinical Features of Post-traumatic Diffuse Cerebral Atrophy

Objective:Clinical features and mechanisms of post-traumatic diffuse cerebral atrophy were retrospectively analyzed.Methods:Twenty-six cases with post-traumatic diffuse cerebral atrophy were examined by CT scan at admission and day 3,weeks 1 and 3,and day 30 after injury.Results:All cases displayed enlargement of bilateral cerebral ventricles,cisterns and sulci and significant atrophy of gyri.Frontal angles of bilateral cerebral ventricles were more than 140°,and index of the caudate nucleus were 16.8%-32.1%(mean 24.2%).Conclusion:The mechanism of these cases with post-traumatic diffuse cerebral atrophy may be related to diffuse damage to the neurons and axons induced by ischemia after injury.