外伤性大面积脑梗死30例临床分析

Clinical study of traumatic large cerebral infarction in 30 patients

目的 探讨重型颅脑损伤并发大面积脑梗死的发病原因、临床特点及治疗。方法 总结３０例经头颅ＣＴ、ＭＲＩ证实为重型颅脑损伤并发大面积脑梗死病例的临床资料及相应的治疗。结果 所有病例出现梗死后，先保守治疗后手术治疗，按ＧＯＳ判断预后的标准，恢复良好９例，中残２例，重残２例，植物生存１例，死亡１６例。结论 重型颅脑损伤颅内血肿病人随时可能并发大面积脑梗死，病死率极高。主要确诊手段是术后常规复查ＣＴ、ＭＲＩ，早期诊断和早期治疗是提高疗效的重要措施。

Objective To summarize the causes,clinical features and management of traumatic large cerebral infarction.Methods The clinical materials and treatment in 30 severe head injury patients with large cerebral infarction were analysed.Results All of the patients had been operated after conservative treatment.Nine cases had a good recovery, 2 cases moderate disability,2 cases severe deficits.1 case was living in persistent vegetative state and 16 cases died.Conclusion Large cerebral infarction could occur at anytime in severe head injury patients with intracranial hematoma.The morfality is high.CT scan or MIR should be taken repeatedly.Early diagnosis and treatment can improve the effects of treatment.