天幕缘切开术治疗嵌顿性小脑幕裂孔疝

Tentorium cerebelli hiatus incision in incarcerated tentorial herniation

目的:探讨重型颅脑损伤并嵌顿性小脑幕切迹疝病人的救治疗效。方法:回顾性分析我院神经外科自2000年6月～2007年7月间手术治疗重型颅脑损伤合并嵌顿性小脑幕裂孔疝21例的临床资料,全组均行标准外伤性大骨瓣开颅行颅内血肿清除并充分的内外减压术,同时加行天幕缘切开术。结果:随访6月～2年,21例中恢复良好4例,中残4例,重残2例,迁延性昏迷2例,死亡9例。结论:天幕缘切开术是重型颅脑损伤并发嵌顿性小脑幕裂孔疝的有效治疗方法。

Objective： To find out the approach for treating severe craniocerebral trauma patients complicated with incarcerated tentofial herniation. Methods ：From June 2000 through July 2007,21 patients with severe craniocerebral injury underwent standard large trauma craniotomy for removal of the hematoma and intra-and extracranial decompression with tentofium cerebelli hiatus incision. The clinical data were reviewed with regard to the procedure and outcome. Results：Of the total 21 cases,4 recovered ,4 were found with moderate disability and 2, severe disability, 2 cases were in persistent vegetative status and 9 died. Conclusion ： Tentorium cerebelli hiatus incision is an effective approach to treatment of severe craniocerebral injury patients with incarcerated tentorial herniation.