重型颅脑损伤后脑干病变的早期核磁共振表现

目的：本探讨重型颅脑损伤后脑干病变的早期核校对共振（MRI）表现。评价颅脑损伤后早期行MRI扫描的价值。方法：对61例重型颅脑损伤后7天内的患进行了MRI检查，同时还做了早期电子计算机体层扫描（CT）采用MRI批描来判定病变的形态学特征；而采用体感诱发电位（SEPs)和听觉诱发电位（BAEOs)来判定脑干功能。结果：39例患（占64%）发现有脑干病变，双侧桥脑病变（100%）死亡，非脑干病变死亡率为9%。在个别情况下，原发性和继发性脑干病变之间有着典型的临床区别。在MRI影像学上，伤后2天以上的所有病变都会出现高信号和1或低信号改变；伤后2天内，原发性病变在MRI影像学上呈低信号改变，而1例继发性脑干病变在MRI影像学上则无出血表现。结论：早期MRI扫描对判断脑干病变具有很大的价值。

Early magnetic resonance imaging of brainstem Lesion after severe head injury

Objective:Early magnetic resonance(MR)imaging of brainstem lesions after severe head injury were studied.The authors assessed the value of MR imaging in the early postinjury period.Methods:MR imaging was performed in 61 consective patients withis 7 days after they suffered a severehead injury.An initial computerized tomography(CT)scan had already been obtained.TO understand the clinical significance of the lesion whose orphological appearance was identified with MR imaging,brainstem function was assessed by registration of somatosensory and auditory evoked potentials.Results:brainstem lesion were visualized in 39 patients(64%).Bilateral Pontine lesion proved to be 100% fatal and nonbrainstem lesion carried a mortality rate of 9%.In singularcases circumstance allowed for a clear distinction between primary and secondary brainstem lesion.On MR inaging all lesion were hyper-and hypointense after intevals longer than 2 dys.Within shorter intervals(<2 days)after the injury,primary lesions appeared isointense on MR imaging.Inone secondary brainstem lesion there were no traces of blood.Conclusion:Eerly MR imaging has great value on diagnosis of brainstem lesions.