外伤性迟发性脑内血肿的CT诊断价值

Diagnostic value of CT on delayed traumatic intracephalic hematoma

目的 探讨外伤性迟发性脑内血肿的旱期CT征象。方法 对32例外伤性迟发性脑内血肿的首次CT检查和复查资料进行对比分析。 结果 (1)首次CT检查在外伤后0.5-3.0 h,主要CT表现:局限性蛛网膜下腔出血27例:局部脑实质密度减低,灰、白质分界不清25例;脑室、脑池变窄,中线结构偏移20例;硬膜下血肿4例,硬膜外血肿2例。(2)外伤后12～72h复查CT,迟发血肿位于额叶20例,颞叶9例,顶叶3例;血肿直径0.5～5.0 cm,其中小于3.0 cm者28例。 结论 外伤性迟发性脑内血肿的早期CT征象及血肿出现时间有其特点,对临床及时正确诊断具有重要的参考价值。

Objective To investigate early CT signs of delayed traumatic intracerebral hematoma. Methods Initial and follow-up CT findings of 32 cases of delayed traumatic intracephalic hematoma were comparatively analyzed. Result Initial CT examinations was performed 0.5-3h after trauma,which presented limited subarachnoid hemorrhage in 27 cases, lowered density of parenchyma and unclear border between gray and white matter in 25 cases,narrowed ventricle and cistern and displaced middle structure in 20cases, subdural hematoma in 4cases and epidural hematoma in 2 cases.Follow-up CT in 12-72h after injury (29 cases in 24-48h) found delayed intracephalic hematomas in frontal lobe in 20 cases, temporal lobe in 9 cases,parietal lobe in 3cases with diameters within 0.5-5.0cm (less than 3 cm in 28 cases). Conclusion Initial CT manifestation and occurring time of the delayed traumatic intracephalic hematoma are characteristic, and provide reliable evidence for timely accurate clinic diagnosis.