早期手术干预双侧额叶脑挫裂伤致中央型脑疝诊治体会

目的探讨双侧额叶脑挫裂伤致中央型脑疝的临床特点和早期手术治疗体会。方法回顾性分析总结近6年内手术救治的32例双侧额叶脑挫裂伤致中央型脑疝患者（手术组）和同期29例双侧额叶脑挫裂伤致脑疝未手术患者为对照组，观察两组患者一般资料、诊断依据、临床表现、治疗方法和疗效。结果GOS判断预后，手术组3分以下患者占37．5％，明显低于对照组62．1％。结论重视额叶脑挫裂伤致中央型脑疝前期或间脑期临床表现，结合影像学特征性表现，及早手术降低颅内压是减少并发症、降低死亡率的有效措施。

Clinical diagnosis and early phase neurosurgical remedy of contralateral frontal cerebral contusion by central brain herniation

Objective To investigate the clinical characteristics and operation for patients with central brain herniation caused by contralateral frontal cerebral contusion.Methods A retrospective study was performed on the medical records of 32 patients with central brain herniation caused(cerebral hernia group)by contralateral frontal cerebral contusion admitted for 6 years,29 patients without surgery in the same period as control group.The clinical manifestations,imaging characteristics,treatment and effect were analyzed.Results The prognosis was evaluated according to GOS score.There were 37.5% under 3 points in cerebral hernia group,significantly lower than those in the control group,62.1%.Conclusion Based on early clinical manifestations of central brain herniation combined with imaging manifestations,bilateral balance decompression can reduce the mortality and morbidity and improve the cure rate of patients with central herniation caused by contralateral frontal cerebral contusion.