脑外伤后急性弥漫性脑肿胀CT表现及其临床意义

２７例脑外伤后急性弥漫性脑肿胀的ＣＴ表现以侧脑室、三脑室及基底池受压或消失为特征。临床预后差。提出ＣＴ诊断标准为：（１）脑室／颅腔比率＜２０％；（２）三脑室部分受压或消失；（３）基底池部分受压或消失。具备其中两项即可诊断。根据脑室脑地受压及中线移位程度将ＣＴ表现分为３型，６个亚型。

Acute Diffuse Brain Swelling after Head Injury:CT Findings and its Clinical Significance

CT scan and prognosis for 27 cases of acute diffuse brain swelling (ADBS)in head injury are reported in this study. CT scanning is characteristic of displaying compressed or obliterated lateral ventricles, third ventricle and basal cisterns. The clinical prognosis was poor. It was found that the CT criteria for ADBS were (1) the ratio of ventricle to craniospace was less than 20%; ( 2) third ventricle was partially compressed or obliterated; ( 3) basal cisterns were partially compressed or obliterarted. If two of these three characteristics were detected, the diagnosis of ADBS could be determined. The results of CT scan in these cases could be classified into three types depending on the compressed degrees of brain ventricles and cisterns, and each of them could also be classified into two sub-types according to mildline shift. In addition, relationship between CT findings and intracranial pressure increase, Glasgow coma scale score and prognosis are also discussed in this paper.