迟发性外伤性颅内血肿的临床及CT特征分析

目的:提高对迟发性外伤性脑内血肿病人的临床症状和CT特征的认识及探讨其最佳CT复查的时间。方法:分析总结46例病人外伤后的各种临床症状和迟发性脑内血肿出现的特点以及第一次复查CT检查的时间。结果:46例病人的临床症状无改善甚至持续加重,并出现神经系统症状;迟发性外伤性脑内血肿大部分出现在脑白质或白质与灰质交界处,以颞叶及额、颞叶交界最多,占52%,额叶次之,占39%,均出现在外伤24h之后,以36h左右最多。结论:可疑有迟发性外伤性脑内血肿的病人最佳CT复查时间为外伤后36h左右。对首次CT扫描未发现脑内血肿的病人,若临床症状持续或逐渐加重,应在外伤后36h左右甚至更早地复查CT,可避免漏诊并及早作进一步治疗。

Clinical and CT features of the delayed traumatic intracerebral hematoma in 46 patients

Objective To improve the know of clinical performance and computer tomograhpy(CT) features of delayed traumatic intracerebral hematoma(DTICH),explore the optimal CT re-examination time.Methods:Analyzed and summarized the clinical performance 、the features of DTICH and the first re-examination time in 46 cases after head external injury.Results:The clinical performance of 46 patients had no the improvement,even aggravate,and appeared the nervous system symptom;mostly of DTICH appeared in white matter,or the boundary of white matter and gray matter,mainly in temporal lobe and boundary of temporal lobe and frontal lobe(52%),then frontal lobe(39%).All the DTICH appeared after 24 hours,mostly about 36 hours.Conclusion: the optimal CT re-examination time of patients with doubted DTICH is about 36 hours.For the patients with no finding at first CT scan,if the clinical symptom keeps on or aggravates gradually,CT re-examination taking in 36 hours even early after head external injury will help to avoid missing diagnosis ,and make early further treatment.