外伤后急性弥慢性脑肿胀的CT诊断与临床分析

目的：探讨外伤后急性弥漫性脑肿胀的CT征象及临床表现。材料与方法：回顾性分析52例外伤后弥漫性脑肿胀的CT征象及临床资料，其中46例患者进行了2—5次CT复查。结果：根据CT表现，将52例患者分为24例弥漫型和28例半球型。所有患者CT均表现为基底池（包括鞍上池、环池、四叠体池、大脑大静脉池）及第三脑室受压变窄或闭塞。其中基底池受压变形或部分变小12例，显著变窄25例，大部分或完全闭塞15例；第三脑室变小或显著变窄28例，闭塞15例，正常9例；第四脑室闭塞13例；双侧或单侧外侧裂池变窄或闭塞34例；脑挫裂伤23例，其中迟发性脑血肿6例，硬膜外或硬膜下血肿12例；中线结构移位39例；脑密度升高或减低44例。结论：基底池和第三脑室变小或闭塞可作为CT诊断外伤后弥漫性脑肿胀的可靠征象，基底池的闭塞可作为重型外伤后弥漫性脑肿胀的诊断依据。

CT Diagnosis and Clinical Analysis of the Post Traumatic Acute Diffuse Brain Swelling

Purpose： To study the CT signs and clinical performance of the posttraumatic acute diffuse brain swelling （PADBS）. Materials and Methods： Retrospective analysis of 52 cases of the PADBS in the CT signs and clinical information, one of the 46 cases of patients 2 to 5 times CT review. Results： According to the performance of CT, patients were divided into 52 cases of the 24 cases of diffuse type and 28 cases of hemispheric type. The basal cistern （ including saddle - up pond, the Central pool, four cistern, cerebral vein pool）and the third ventricle narrowing or occlusion in all patients in the CT signs. Basal cistern compression deformation or smaller in 12 cases, 25 cases significantly narrowed, the majority or total occlusion in 15 cases. The third ventricle significantly smaller or narrower in 28 cases, 15 cases with obstruction, 9 eases with normal. The occlusion of the fourth ventricle in 13 cases. The of narrowing or occlusion with Bilateral or unilateral lateral fissure pool in 34 cases. In the 23 cases of cerebral contusion, 6 cases were delayed cerebral hematoma. Epidural or subdural hematoma in 12 cases. The displacement of midline structures in 39 cases. Increase or reduce the density of the brain in 44 cases. Conclusion： The narrowing or occlusion in basal cistern and third ventricle may become reliable signs in CT diagnosis of PADBS, the occlusion of basal cistern can be used CT signs in the severe PADBS.