额叶挫裂伤致脑中心疝31例临床分析

目的:探讨额叶挫裂伤致脑中心疝的临床与影像学特点,选择有效治疗方法。方法:回顾性分析31例额叶挫裂伤致脑中心疝患者的临床症状、影像学特征、治疗方法,并结合国内外资料探讨额叶挫裂伤致脑中心疝的诊断、治疗。结果:瞳孔缩小时手术16例:死亡和重残4例,轻残和良好12例。瞳孔散大后手术8例,均为死亡和重残。保守治疗7例。均为死亡和重残。结论:额叶挫裂伤,尤其是双侧额叶挫裂伤患者发生的脑疝大部分为脑中心疝,其CT特征性表现为侧脑室、三脑室、鞍上池、环池、四叠体池等受压变形,间脑期是抢救关键时期。

Clinical Analyze of Brain Central Hernia Caused by Frontal Lobes Contusion and Laceration

Objective:To Investigate the clinical and imaging characters of contusion and laceration of frontal lobe of brain and select the efiecfive treatment.Methods:The character of 31 central hernias of brain caused by frontal lobes contusion and laceration were retrospectively analyzed and their clinical signs and symptcms,imaging findings and treatment methods were discussed in combination with reviews of domestic and abroad literatures.Results:The results of 16 cases who accepted operation when the pupil a contracted were that 4 cases died or severe deformities,12 cases having moderate deformities or being well.The result of 8 cases who accepted operation when the pupil dilated was dead or seriously morbid.The results of 7 cases accepted conservative treatment was dead in or serious morbility.Conclusion:Most brain hernia caused by frontal lobes contusion and laceration was central hernia,especially bilateral frontal lobes contusion and laceration.The characters in CT image of this hernia was that lateral ventricle,third ventricle,basilar cistern,ambient cistern and corpora quardrigemina cistern was compressed and deformed.Diencephalons period was the key period for salvage.