创伤性脑梗塞15例治疗体会

FIFTEEN CASES OF TRAUMATIC CEREBRAL INFARCTION

报告外伤和手术后脑梗塞15例,并命名为创伤性脑梗塞。15例均于伤后1周內发病,小儿(10例)较成人多见。CT显示梗塞灶共18处,其中左、右基底节各7例, 右额颞部、脑干及右枕叶各1例,平均直径0.6cm～4.0cm,CT值2～20Hu。动脉内膜损伤、出血、痉挛和血液高凝状态是发病的主要环节。本组全部采用保守治疗,结果痊愈13例、轻残1例、重残1例,无植物状态及死亡。

We report 15 cases of cerebral in farction eccurring after craniocervical blunt trauma and operation, and name it traumatic cerebral infarction (TCI). This complication occurred in 2.6％ of 599 consecutive blunt traumatic and surgical cases admitted from Feb. 1988 to Feb. 1991, and was treated for 6 months. All the TCI occurred within the first week after trauma or surgery. In these patients, children (10 cases) were more than adults A computerized tomography scan demonstrated that: in the 15 patients, there were a total of 18 localized low-density infarct areas, their diameters ranging 0.6—4.9cm; these infarct foci were found respectively in the left basal nucleus (7 cases), in the right basal nucleus (7 cases), in the right frontaltemporal area (1 case), in the encephalic truncus (1 case) and in the right cecipital lobe (1 case). The pathogenesis of TCI was related to intimal tear, bleeding and spasm of the internal carotid artery and cerebral artery, and aotivated coagulins of blood. The patients treated with conservative treatment had a good outcomes. The outcomes were divided into 4 categories: good recovery (13 cases), moderately disabled (1 case), severely disabled (1 case), and vegetative/dead (none).