外伤性基底节区血肿42例临床分析

目的 研究外伤性基底节区血肿（TBGH)的发病机理、临床特点及预后因素。方法 回顾分析了42例TBGH病人的临床资料。结果 TBGH常见于车祸所致的减速性损伤,血肿多位于受力对侧;伤后早期出现偏瘫而意识障碍相对较轻为临床特征;年龄大于60岁、原发性脑损伤重、血肿量大于30ml、瞳孔异常、GCS评分小于8分死亡率高。结论 “中间脑挫伤”概念可解释TBGH形成;其临床表现具有特征性,正确认识该病,动态CT可明确诊断;原发性脑损伤程度、年龄、瞳孔变化、血肿量、意识状态是影响预后的主要因素。

Clinical Analysis of Traumatic Hematomas of Basal Ganglia in 42 Patients

Objective To study the pathogenesis,clinical characteristics and prognosis in the patients with traumatic basal ganglia hematoma(TBGH).Method The clinical data of42patients with TBGH was analyzed retrospectively.Results TBGH was often produced by decelerating craniocerebral injury and located frequently in the side contralateral to impacted side.The clinical features of TBGH were hemiplegia and relatively good consciousness early after the injury.High mortality was usually observed in the patients who were over sixty and suffered from severe primary brain injury(GCS<8),or in whom hematoma was larger than30ml and abnormal pupil occurred.Conclusion The mechanism of pathogenesis may be interpreted by the concept of"intermediary contusion"of TBGH.TBGH is of distinct clinical characteristics.Serial CT scans may be helpful to making early diagnosis.The age of patients,severity of brain injury,pupillary change,size of hematoma and the level of consciousness were the main factors influencing the prognosis of the patients with TBGH.