婴幼儿外部性脑积水的临床CT分析

目的：进一步提高对婴幼儿外部性脑积水的认识水平。材料与方法：本组23例外部性脑积水，男19例，女4冽，年龄1个月至1岁半。新生儿缺氧缺血性脑病11例；抽搐6例；发热、抽搐伴外伤1例；化脓性脑膜炎治愈后1例；头围增大、步行困难，前囱早闭各1例；有外伤史而无其他不适1例。全部病例均作横断面CT扫描。详细分析了它们的CT所见，并探讨了它们与临床的关系。结果：23例均有双侧额部对称性蛛网膜下腔增宽，相应部脑沟加深，并延至双项部老13例，延至双侧颞部者4例；23例均有前纵裂增宽；双外侧裂池增宽20例；鞍上池扩大7例；哈（Huckman）氏值大于35mm者18例。结论：婴幼儿外部性脑积水位于额预部，与前囱末闭有关。外部性脑积水的原因很多，多见于新生儿缺氧缺血性脑病的恢复期。外部性脑积水可能与蛛网膜粒发育迟缓或脑脊液分泌增多有关。

Clinical and CT Analysis of Extracerebral Fluid Collections in Infants

Purpsoe: To improve ability of rccognizing extracerebral fluid collections in infants. MateriaIs and Methods: 23 extracerebra1 fluid collections cases. in which 19 cases were rnale, and 4 were fema1e. Their ages were from 1 to 18 months. In this group, 11cas had been ill with neonatal ischemic and anoxic cerebropathy, 6 cases had spasm, l case had fever and spasnl and becn traumatized, l case had cured purulent meningitis, 1 case had head circumference enlargement, l case had dysbasia, l case had early closure of frontaI fontanel and l case had only been traumatized without clinical symptom. All the cascs were obtained from craniocercl'ral axial CT scans. Their CT findings were analysed in detai1s. The correlation between their CT and clinica1 findings were investigated. Results: There were sytnmetrical subarachnoid cavity wideness and cerebral sulci deepeness in both frontal lobes in a1l cases, extending to both parietal lobes in 13 cases, and to both temPOral lobes in 4 cases. There were anterior interhemispherical fissure cistern wideness in all cases, 20 cases had bilatera1 sylvian fissurc cistcrn wideness and 7 cascs had suprase1lar cistcrn enlargement. Huckman valL1e was > 35mm in 18 cases. Conclusions: Extracerebral fluid collections locates in frontopartietal lobc and reIates to unc1osLlre of frontal fontanel.Extracerebral fluld collection results from vari()us causcs, cornmo1lly secn in recovery stage of neoIlatal lschenlic and anoxlc cerehropathy.It may be related to developmentaI retardation of arach11oid granulations and cerebrosPinal fluid hypersecretion.