外伤性蛛网膜下腔出血诊断

目的:探讨外伤性蛛网膜下腔出血的诊断。方法:对以外伤后头痛头晕症状明显为主诉,3d内症状无明显缓解的患者92例为研究对象,结合体征及头颅CT检查结果行腰穿检查。结果:头颅CT提示脑皮质点片状高密度影及脑池、脑沟高密度影及可疑脑池、脑沟高密度影患者腰穿结果均证实有蛛网膜下腔出血。头痛头晕症状明显头颅CT检查未见异常患者行腰穿90%证实有蛛网膜下腔出血。结论:无论是否伴有恶心呕吐症状或脑膜刺激征,头颅CT提示脑皮质点片状高密度影及脑池、脑沟高密度影及可疑脑池、脑沟高密度影患者均符合蛛网膜下腔出血的诊断。头痛头晕症状明显头颅CT检查未见异常3d内症状无明显缓解的患者要高度怀疑蛛网膜下腔出血的可能。外伤性蛛网膜下腔出血脑膜刺激征表现可不明显。

Diagnosis of traumatic subarachnoid hemorrhage

Objective:To investigate the diagnosis of traumatic subarachnoid hemorrhage.Methods:92 patients with symptoms of headache and dizziness obviously after trauma,no obvious remission within 3 days,examination with lumbar puncture according to physical sign and CT features.Results:All the patients are verified subarachnoid hemorrhage with CT findings suggested dot and slice high density in ectocinerea,high density in cisterna or brain sulcus,dubious high density in cisterna or brain sulcus.90 percent of patients are verified subarachnoid hemorrhage with symptoms of headache and dizziness obviously and normal CT features.Conclusions:All the patients tallied with the diagnosis of subarachnoid hemorrhage with CT showing dot and slice high density in ectocinerea,high density in cisterna or brain sulcus,dubious high density in cisterna or brain sulcus wether or not with symptoms of nausea and vomitus or meningismus.The patients with symptoms of headache and dizziness obviously and no obvious remission within 3 days and normal CT features should be suspected the diagnosis of subarachnoid hemorrhage highly.Traumatic subarachnoid hemorrhage meningeal irritation may be not obviously.