摘要
目的探讨外伤性迟发性颅内血肿CT及临床特点,以提高对外伤性迟发性颅内血肿临床诊断准确率与治疗效果。方法回顾性分析我院2007～2008年40例CT证实的外伤性迟发性颅内血肿CT表现及临床表现特点,年龄4～74岁,中位年龄32岁。均有外伤史。结果本组40例均有如下情况之一者:伤后3～5天内或术后有进行性意识障碍,出现新的局限性神经定位体征和局限性癫痫者13例;颅内血肿成功清除后,或去骨瓣减压后,临床症状无改善或改善后又恶化者10例;颅脑多发复合伤,有内出血、低血压、曾输大量血及液体,血压稳定后意识未见明显好转者3例;伤后经积极有效治疗,病情无改变或进一步恶化;特别有过度换气,脑脊液漏或脑室外引流,强力脱水者4例;有颅骨骨折的病人,首次CT检查未发现颅内病变,但病情无改善者10例。伤后或术后24h、48h、72h复查CT证实均有外伤性迟发性颅内血肿。结论有头部外伤史,首次CT检查未发现颅内病变,或颅内血肿成功清除后,但临床症状及体征无改善者。应考虑到有外伤性迟发性颅内血肿的可能,应伤后或术后24h、48h、72h复查CT。
Objective To analysis the features of CT and clinical manifeststions about the delayed traumatic intracerebral hematoma to improve the diagnosis and the treatment. Methods 40 cases who had been diagnosed as delayed traumatic intreeerebral hematoma during 2007 - 2008 in my hospictal were analyzed. All of the cases had history of injury, and the average age was 32. Results 13 cases had the symptoms of progressivity conscious disturbance, focal neurosigns or epilepsy after injury or operation; IO cases had the clinical manifeststions which are constant or aggravate after the operation of move the skull or the hematoma;3 cases were in a state of unconsciousness after combined injury of brain,internal hemorrhage or hypotension who had been treated by transfusion; 4 cases had the symptoms of hyperventilation,leakage of cerebrospinal fluid,external ventricular drainage or water deprivation; 10 cases＇ symptoms had no improvement after treatment who with the fracture and the delayed intrecercbral hematoma（ diagnosed by the CT imaging after 24hs,48hs or 72hs）. Conclu- sion If the symptoms of the case who has the history of craniocerebral trauma without improvement, we must consider the possible of the delyed. Traumatic Intracerebral hematoma and it is necessary to have CT scan by 24hs,48hs,72hs or after operation.
出处
《医学研究杂志》
2009年第7期105-108,共4页
Journal of Medical Research
