78例儿童外伤性腔隙性脑梗塞的诊治

Diagnosis and therapy of traumatic cerebral lacunar infarction in children （report of 78 cases）

目的探讨儿童外伤性腔隙性脑梗塞的临床特点和诊治方法。方法回顾性分析78例外伤性腔隙性脑梗塞患儿的临床症状、影像学表现、治疗方法及预后。结果全部患儿均发生于颅脑损伤后，主要临床表现为肢体运动障碍、头痛、呕吐等，经CT和MRI扫描明确诊断，予药物、高压氧及肢体功能训练等综合治疗。痊愈64例（82．1％），遗留轻度残疾12例（15.3％），重度残疾2例（2．6％）。结论在儿童外伤．f生腔隙性脑梗塞的诊断上，MRI优于CT检查，早诊断、早期综合治疗有助于提高临床疗效。

Objecitive To summary the clinical features, and to discuss the therapeutic treatments of traumatic cerebral lacunar infarction in children. Motheds The clinical symptoms, imaging findings, treatment and outcome of 78 children with traumatic cerebral lacunar infarction were analyzed retrospectively. Results The traumatic cerebral lacunar infarction was identified in all children by computer tomography（ CT）scan and magnetic resonance imaging （MRI）scan. The clinical symptoms were limb movement disturbance, headache and vomit. The therapeutic treatments were drug administration, hyperbaric oxygen therapy, and extremity functional training. Among all children, the assessment of outcome was full recovery in 64 （82.1%）, mild disability （ 15.3% ）in 12 and severe disability in 2 （2.6%）. Conclusions Compared with CT, MRI is more effective in diagnose the traumatic cerebral lacunar infarction in children. The outcome of traumatic lacunar infarction can be improved by early diagnosis and combined therapy.