枕部着力致颅脑损伤CT特征及诊断要点

CT manifestations and diagnostic main points of head injury resulted from hit on occiput

目的总结枕部着力致颅脑损伤的CT特征。方法154例患者经手术后,回顾其CT改变与手术结果对照分析。结果所有病人均有局部头皮损伤,颅骨骨折98例,脑肿胀93例,蛛网膜下腔出血99例,跨颅内或跨幕上/下硬膜外血肿25例,小脑挫伤3例,小脑半球出血2例,幕上对冲性脑挫裂伤127例,硬膜下血肿119例,脑内血肿67例,硬膜外血肿49例,原发性脑干损伤2例,小脑幕裂孔疝41例及枕骨大孔疝6例。结论枕部着力致颅脑损伤以弥漫、多发伤为主,且多以迟发或复查时加重为特点。充分认识迟发性后颅窝硬膜外血肿的早期CT改变及枕骨大孔疝的CT征象,可以降低病人猝死率。

Objective To sum up the characteristics of the CT manifestations of head injury resulted from hit on occiput. Methods After operations,we studied the changes of the CT manifestations of the 154 cases and contrasted the changes with operational results. Results The 154 cases suffered from partial scalp injury. Other injuries included： fracture of skull （n=99）, brain swelling （n=93）, subarachnoid hemorrhage （n=99）, epidural hematoma of posterior cranial fossa or across tentorium （n=25）, cerebellar contusion （n=3）, cerehellar hemisphere hematoma （n=2）, supratentarial contrecoup contusion of brain （n=127）, subdural hematoma （n=119）, epidural hematoma （n=49）, intraeerebral hematoma （n=67）, transtentorial hernia（n=41）, primary brain-stem injury （n=2）, tonsillar hernia （n=6）. Conclusion Head injuries resulted from hit on oceiput are characterized by diffusion, mult-Computer aided surgery, recognition of earlier diagnosis of posterior cranial fossa epidural hematoma can reduce the occurrence rate of tonsillar hernia, low sudden death rate of patients.