外伤性大面积脑梗死的临床研究

Clinical investigation of severe brain infarction secondary to brain injury

目的探讨外伤性大面积脑梗死的发病机理、早期诊断与治疗要点。方法回顾总结外伤性大面积脑梗死15例的临床资料。6例手术治疗,9例保守处理。结果发病6个月后按GOS标准评价,本组病人死亡6例,重残4例,中残3例,良好2例。结论外伤性大面积脑梗死的发病机理与血液流变学变化、血管内皮损伤、血管的解剖学特点等因素有关。对于颅脑外伤病人根据病情变化及时复查CT,对本病力求早期发现,早期治疗,以提高治疗成功率。

Objective Clinical and radiological character, mechanism, earlier diagnostic and therapeutic methods of brain infarction with large area secondary to brain injury was investigated. Methods Clinical data and process of earlier diagnosis and therapy for 15 patients were summarized. Among these patients 6 were treated by operation. Results The clinic efficiency was assessed by GOS 6 months after brain trauma. Of 15, 6 cases died as grade 1,4 cases as grade Ⅲ ,3 cases as grade Ⅳ and 2 eases as grade Ⅴ. Conclusions The mechanism of brain infarction with large area is associated with the change of hemodynamic, the injury of endangium and the character of vascular anatomical form. Intensive observation and subsequent CT scanning should be performed for brain injury patients. To enhance the survival rate, earlier diagnosis and therapy for brain infarction with large area secondary to brain injury timely is the key.