心源性脑梗塞合并早期天幕疝的CT诊断

CT Evaluation of Transtentorial Hernia in Patients of Cardiogenesis Infarct

目的：探讨心源性脑梗塞合并早期天幕疝的CT表现。材料与方法：作者回顾性分析20例心源性脑梗塞合并单侧颅内压增高病人的平行OM线扫描CT图像，全部病人均经斜坡垂线CT扫描法证实存在早期天幕疝。结果：脑疝组中，病变侧脑室受压变形、中线结构向对侧移位20例，中线移位程度大于1.5cm时14例，病变侧脑沟明显受压消失20例，中间帆腔变窄20例，四叠体池及大脑静脉池变形或闭塞20例，外侧裂池及鞍上池闭塞11例，大脑大静脉池内见与海马回相连的软组织块9例。结论：平行OM线CT扫描图像仅能对部分早期天幕疝的病人做出诊断；平行OM线CT扫描图像上，大脑大静脉地内见与海马回相连的软组织块为天幕疝的特征性CT表现。

Purpose:To evaluate the transtentorial hernia in patients with cardiogenesis infarct on CT. Materi-als and methods:Twenty patients of cardiogenesis infarct with ipsilateral increased intracranial pressure were stud-ied retrospectively. All the patients were proved with transtentoral hernia based on the finding of temporal lobe de-scended into infratentorium on the imaging obtained with vertical-to-clivus scarining methood. Result =In 20 pa-tients,midine shift was seen. Encroachment on the ipsilateral hemicerebral sulci in 2O patients,on the sylvian fis-sure and suprasellar in 11. The degree of midline shift more than 1. 5cm in 14 patients,hippocampal dislocated toGalen s vein cistern was seen 9 cases. Conclusion:In CT Scans paralleling to OM line,nearly half patients can be di-agnosed based on the signs that hippocampal dislocated to Galen's vein cistern.