额叶挫裂伤致脑中心疝临床分析

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24例额叶挫裂伤致脑中心疝的临床特点,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。结果手术病人均采取内或(和)外减压术。瞳孔缩小时复查头颅CT18例,手术16例,生存12例。保守治疗2例,均死亡。瞳孔散大后复查头颅CT 6例,手术4例,死亡3例,生存1例(重残),保守治疗2例,均死亡。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,间脑期是抢救关键时期。

Clinical analyze of brain central hernia caused by frontal contusion and laceration

Objective To Investigate clinical and imaging character and select effiective treatment.Methods The character of 24 brain central hernia cases caused by frontal contusion and laceration was retrospectively analyzed and their clinical signs and symptoms,imaging findings and treatment methods were discussed in combination with domestic abroad literature.Results All operate patient with inside/outside decrease-pressure operation.18 head CT when pupil reduced,16 operation,12 live.2 with conservative treat and all dead.6 head CT when Pupil enlarged,4 operation,3 dead,1 live(serious cripple),2 with conservative treat and all dead.Conclusion Most hernia caused frontal contusion and laceration is brain central hernia,especially bilateral frontal contusion and laceration.Diencephalons period is the key period for salvage.The patient's clinical signs include deepened consciousness,lateral or bilateral pupil becoming reduced.