儿童外伤性脑梗塞的临床诊断与发病机理研究

DIAGNOSIS AND PATHOGENESIS OF CEREBRAL INFARCTION AFTER HEAD TRAUMA IN CHILDREN

１６例１１个月至１４岁的儿童外伤后脑梗塞，主要临床特点为外伤后伴有或不伴有短暂意识障碍，外伤后１～２４ｈ出现肢体瘫痪。颅脑ＣＴ检查示梗塞周围有轻微水肿，无占位效应，４例ＭＲＩ扫描的结果与ＣＴ检查相符，４例行ＭＲＡ血管造影证实无血管狭窄及畸形。经内科治疗，７例基本痊愈，９例显著好转，预后良好。对本病发病机理及预后良好的原因进行了讨论。

Sixteen cases of cerebral infarction after head trauma in children aged 11 monthes to 14 years were reported. The main clinical features were trauma with or without transient disturbance of consciousness;limb palsy usually occured during 1 to 24 hours after trauma. CT scan showed a slight swelling arround the infarction without space-occuping effection.MRI were investigated in four cases and the results were in accordance with CT scan. MRA angiography were investigated in four cases and the results demonstrated no visual stenosis and malformation.After treatment, seven cases were elementarily cured, nine cases significantly improved and the prognosis was good. Finally the pathogenesis of the disorder and reason of good prognosis were discussed.