老年人颅脑外伤后缺血性脑卒中发作特点及治疗

目的探讨老年人颅脑外伤后缺血性脑卒中发作特点及个性化治疗方案。方法针对7例颅脑外伤后急性期出现缺血性脑血管病症状的老年患者，通过脑血管造影检查分析其发病原因并根据不同的脑血管特点决定治疗方案。结果大多数患者（6／7）受伤前已存在不同程度的颅内外血管狭窄、血管壁溃疡以及附壁血栓形成等改变，提示脑缺血发作主要与这些病变为基础的脑血流下降、血栓脱落等因素密切相关。而外伤后脑灌注降低、脑血管痉挛是脑缺血发作的诱发因素。结论老年人外伤后的缺血性脑卒中发作主要与原有的脑血管基础疾病有关，预防和治疗老年人外伤后缺血性脑卒中发作，应基于这些病变特征并选择个体化治疗方案。

Characteristic and treatment of ischemic stroke in senior patients after traumatic brain injury

Objective The purpose of this study is to investigate the characteristic and individual treatment of ischemic stroke in senior patients after traumatic brain injury. Methods 7 senior patients with ischemic stroke after traumatic brain injury were followed-up in this study. All of those patients received cerebral angiography ,morbility mechanism was analysised and therapeutic regimen was designed according to different feature of cerebral vessels. Results Majority patients （ 6/7 ） presented changes to a certain extent before injury, such as cerebral angiostenosis, angielcosis and mural thrombosis. This shows that ischemic stroke after traumatic brain injury is closely related to factors such as decrease in cerebral blood flow and thrombosis. And decrease in cerebral perfusion after brain injury and cerebral angiospasm are the causative factors. Conclusion Ischemic stroke in senior patients after traumatic brain injury is mainly related to intrinsic cerebral vessel disease. Therefore, prevention and treatment for ischemic strokes in senior patients after traumatic brain injury should be based on its characteristic ,and the treatment should be individualized.