幕上大面积脑梗塞伴脑疝的外科治疗

Surgical Treatment of Cerebral Hernia Induced by Supratentorial Massive Cerebral Infarction

目的探讨幕上大面积脑梗塞伴小脑幕切迹疝的外科治疗方法。方法对2001年1月至2006年3月采用标准外伤大骨瓣减压、颞肌贴敷术救治的17例幕上大面积脑梗塞伴小脑幕切迹疝病例进行回顾性分析。结果按GOS评分进行疗效评价,其中恢复良好6例(35.29%,6/17),中残3例(17.65%,3/17),重残4例(23.53%,4/17),植物生存1例(5.88%,1/17),死亡3例(17.65%,3/17)。结论标准外伤大骨瓣减压、颞肌贴敷术是治疗幕上大面积脑梗塞伴小脑幕切迹疝的有效方法。

Objective To explore the surgical treatment of transtentorial hernia induced by supratentorial massive cerebral infarction. Method The clinical data of 17 patients with transtentorial hernia induced by supratentorial massive cerebral infarction, who were treated by standard large trauma craniotomy and roofing of temporal muscles from January, 2001 to March, 2006, were analysed retrospectively. Results According to Glasgow outcome scale, there was good recovery in 6 patients （35.29%, 6/17）, moderate disability in 3 （17.65%, 3/17）, severe disability in 4 （23.53%, 4/17）, vegetative survival in I （5.88%, 1/17） and 3 （17.65%, 3/17） died. Conclusion Standard large trauma craniotomy and roofing of temporal muscle were effective method to treat transtentorial hernia induced by supratentorial massive cerebral infarction.