顶枕着力双额脑挫裂伤的临床特点与治疗

Clinical features and treatment of contusion and laceration of bilateral frontal lobes resulted from the impact over parietal-occipital area

目的探讨顶枕着力所致双额脑挫裂伤的临床特点与治疗方法。方法分析57例患者临床资料,31例急症开颅去骨瓣减压手术,26例行非手术治疗。结果恢复良好35例,中残7例,重残5例,死亡10例。在非手术治疗期间因病情恶化中转手术12例,其中5例为突发脑疝后紧急开颅。结论顶枕着力双额脑挫裂伤的病情易出现突变,去骨瓣减压、解除颅内高压是改善预后的关键。

Objective To discuss the clinical features and treatment of contusion and laceration of bilateral frontal lobes resulted from the impact over the parietal-occipital area. Methods The clinical data were retrospectively analyzed in the 57 cases admitted by our hospitalbecause of contusion and laceration of bilateral frontal lobes induced by the force onto the parietal-occipital area. In the 57 cases, 3 l were treated with emergent decompressive craniotomy with the removal of bone flap, while the other 26 with non-operative treatment. Results Favorable recovery was seen in 35 cases, moderate disability in 7 cases, severe disability in 5 cases and death in 10 cases. During the non-operative treatment, 12 cases were shifted to undergo the craniotomy for the aggravating conditions, among them, 5 cases for abrupt cerebral hernia. Conclusion The conditions of the patients with bilateral frontal contusion and laceration due to the impact onto parietal-occipital area are apt to worsen abruptly. Active operation and removal of bone flap for decompression, elimination ofintracranial high pressure were vital to improve the prognosis.