外伤性小脑幕裂孔下疝的CT表现

目的认识外伤性小脑幕裂孔下疝的CT征象,并探讨其对判定第四脑室继发性缩窄的意义。方法临床上出现双侧瞳孔散大的103例重型颅脑损伤病例均经CT扫描,对所有病例的CT表现进行了回顾性分析。结果103例均有第四脑室改变。第四脑室变化按缩窄程度分为闭塞、重度狭窄、轻度狭窄3组,其中,第四脑室闭塞型62例,重度狭窄型28例,轻度狭窄型13例。第四脑室伴有变形移位共36例,68例中脑和脑桥有明显变形、移位或伴有旋转,脑干界面消失35例。脑桥小脑角池双侧闭塞87例、一侧扩大16例。结论第四脑室闭塞或狭窄是CT诊断小脑幕裂孔下疝的可靠征象。

CT findings of traumatic cerebello- tentorial gap hernia

Objective To understand the CT findings of traumatic cerebello-tentorial gap hernia and to discuss their significance for identifying the secondary stricture of the fourth ventricle.Methods A hundred and three patients with clinically presented serious brain injury associated with bilateral corectasis underwent CT scans of the head. CT findings of all patients were analyzed retrospectively.Results On CT images,the changes of the fourth ventricle were found in all patients.According to the stricture degree,the changes of the fourth ventricle could be divided into three patterns which comprised occlusion(n=62),serious stricture (n=28)and mild stricture(n=13).The complicated deformity and displacement of the fourth ventricle were found in 36 cases,obvious deformity and displacement of midbrain and pons or associated with rotation in 68,disappearance of brainstem interface in 35.Bilateral occlusion and unilateral enlargement of pontocerebellar cistern were found in 87 and 16,respectively. Conclusion The occlusion and stricture of the fourth ventricle are reliable CT signs to diagnose traumatic cerebello-tentorial gap hernia.