外伤性蛛网膜下腔出血动态CT扫描观察

Traumatic subarachnoid hemorrhage:observation by dynamic CT scanning

目的探讨外伤性蛛网膜下腔出血患者颅内CT影像学变化与预后的关系。方法对128例以首次CT检查为外伤性蛛网膜下腔出血的病例,分别于伤后24、72h再次进行CT扫描,观察颅内影像学变化,对全部患者伤后随访6个月,分析影像学变化与预后的关系。结果 24h后CT发现颅内蛛网膜下腔出血量增加22例,减少58例,相似48例;72h后增加2例,相似14例,减少112例。随访6个月(GOS)评定恢复良好109例、中度伤残12例、重度伤残4例、植物生存状态1例和病死2例。结论影像显示外伤性蛛网膜下腔出血患者伤后72h出血趋于减少或停止,单纯外伤性蛛网膜下腔出血者多预后良好,但合并颅内其他严重损伤时预后较差。

Objective Tostudythe dynamic CTimagingchanges followingtraumatic subarachnoid hemorrhage（TSH）and toanalyze their correlation with the prognosis.Methods A hundred and twenty-eight patients with TSH underwent repeated CT scans at 24 h and 72 h following posttraumatic-initial CT examinations.The intracranial CT imaging changes in all the patients were followed-up for six months,while the correlation between the imaging changes and the prognosis was analyzed for each case.Results At posttraumatic 24 h repeated CT scans showed that 22 cases whose TSH volume in comparison with first measurements was increased,58 cases whose that was decreased,and 48cases whose that was unchanged,while at posttraumtic 72 h repeated CT scans showed that only 2 cases whose TSH volume was increased,14 cases whose that was unchanged,and 112 cases whose that was decreased.The evaluation according to GOS during follow-up period of six months suggested that there were 109 good recovery,12 moderate disability,4 severe disability,1 vegetable,and 2 death in 128 TSH patients.Conclusion When posttraumatic 72 h,TSH in most patients tends to decrease or even stop.Most patients with simple TSH had good outcome but few patients who associated with severe intracranial injuries had poor outcome.