脑弥漫性轴索损伤与原发性脑干损伤的比较

Comparative study on diffuse axonal injury and primary brainstem injury

目的比较脑弥漫性轴索损伤(DAI)与原发性脑干损伤(PBSI)的异同,为正确诊治提供依据。方法根据临床症状和CT/MRI特征,对46例DAI和20例PBSI进行回顾性分析和随访。结果DAI组中,CT/MRI发现合并脑干损伤12例;PBSI组中,CT/MRI阴性或仅有蛛网膜下腔出血(SAH)7例,单纯脑干损伤1例,合并其它部位脑损伤12例。结论DAI是常见的弥漫性脑损伤,包括合并存在的脑干轴索损伤;PBSI是脑干的原发性损伤,包括原发于脑干的轴索损伤、挫裂伤和血肿。DAI和PBSI存在交叉。

Objective To compare the similarity and difference of diffuse axonal injury （DAD and primary brain stem injury （PBSI） for providing a good reference for diagnosis and treatment. Methods Based on the clinical symptom and the character of CT/MRI, we analyzed retrospectively and followed up 46 DAI cases and 20 PBSI cases. Results Among the patients diagnosed as DAI, 12 cases were found to be injured on the brain stem under CT/MRI scan. While among the patients diagnosed as PBSI,7 cases were found to be non-abnormal or only had SAH under CT/MRI scan, 1 case was found to be injured only on the brain stem, and 12 cases were on the other part of the brain at the same time. Conclusion DAI is a kind of familiar diffuse brain injury including the axonal injury of the brain stern. PBSI is a kind of primary injury on the brain stem,which includes the primary axonal injury of brain stem and the contusion or hematoma of the brain stern. DAI and PBSI are crossed each other.