创伤性局部脑水肿CT动态变化的研究

Dynamic Changes of CT Scan of Focal Brain Edema After Head Injury

目的了解外伤后局部脑水肿发生发展的动态变化的规律。方法选择本院1998～2002年进行过多次头部CT扫描的脑外伤病人120例,记录每次CT扫描多项影像学及相关临床指标,并对这些指标进行统计分析。结果本组96.7%的病人CT上显示局部水肿,水肿多在伤后7h出现,9d达到水肿高峰,其形态有向圆锥形发展的趋势,并有皮层回避的特点。结论外伤后局灶性脑水肿普遍存在。灰质和白质在组织结构、血供等方面的差异可能是引起水肿圆锥形态和皮层回避的原因。了解这些规律对于预计水肿的发展趋势,指导临床治疗有重要意义。

Objective To study the dynamic changes of posttraumatic focal brain edema. Methods 120 patients who underwent multiple CT scans after head injury with hematoma or brain contusion in our hospital from 1998 to 2002 were enrolled in this study. Their CT image parameters and clinical data were recorded, and statistically analyzed. Results 96.7%(116/120) patients had perihematoma or pericontusion edema. Edema appeared 7 hours after head injury and reached its climax at the ninth day. Edema shape trended taper during its development, and cortex escaped from edema. Conclusion Focal brain edema was very common in the patient with head injury. Taper shape's formation and escape of cortex may mainly attribute to the difference in construction topology and blood supply between cerebral white and gray matter.