脑内张力性血肿的诊断与治疗体会

目的探讨脑内张力性血肿临床规律及有效治疗方法。方法经CT扫描诊断并为手术证实的脑内张力性血肿共12例,对其头部CT扫描片、临床表现特点、治疗经过等回顾分析。结果所有12例中高血压性脑出血10例,外伤性脑内血肿2例。发病初期血肿量均为20ml以下,均于发病7～10d左右,临床症状加重,CT扫描可见高密度血肿灶周围出现环形低密度改变,并伴有明显占位效应,还是诊断脑内张力性血肿的主要依据。结论如及时施行颅骨钻孔,血肿穿刺抽吸手术,病情则会迅速好转,预后良好。

Preliminary study of surgical treatment of acute cerebellar infarction

Objective To study the therapeutic significance of operation via the posterior fossa in the treatment of acute cerebellar infarction. Method Retrospective study of the clinical materials of 12 cases with acute cerebellar infarction which were successfully cured by operation via the posterior fossa in recent years. Results Acute cerebellar infarction,the infarction territory lies in the inner part of cerellar hemisphere,were caused by the occlusion of the superior cerebellar artery,the cerebellar cistern circulation were influenced directly by the consequent hydrocephaus and cerebellar infarct.These caused the continuous increase of intracranial pressure and further herriation to death. All of 12 cases were performed by the operation via the posterior fossa when the syndrome were aggregated companied by the loss of consciousness.After the surgery,the syndrome of herriation were released,consciousness recovered and the patients were cured. Conclusion The operation via the posterior fossa,dissection of infarct,improvement of cerebellar cistern circulation and releasing from the herriation eventually is an effective treatment for acute cerebellar infarction cases as soon as they were accompanied by herriation.