利器致颅脑穿透伤三例报告并文献复习

Penetrating stab injury of the brain： eases reports and literature review

目的探讨利器致颅脑穿透伤的发生特点、主要并发症及手术治疗策略。方法分析3例利器致颅脑穿透伤病例的病例特点，并文献复习。结果3例病例均发生在非常见部位，1例引起了大脑前动脉的损伤，并引起下视丘损伤、脑脊液鼻漏及颅内感染，另2例引起了静脉窦的损伤，手术后3例患者均有较好的预后。结论利器致颅脑穿透伤可发生在头颅各部位，临床表现主要与直接损伤的组织结构有关，需注意脑脊液漏、颅内感染等并发症；动脉、静脉窦的损伤需在充分术前准备的情况下，术中及时恰当处理可取得较好预后。

Objective To discuss the mechanism,major complications, surgical treatment strategies of penetrating stab injury of the brain. Methods Three cases of penetrating stab injury to the brain were analyzed. The relevant literatures were reviewed. Results In the cases, the injury sites of the skull were uncommon. In case one, the tool damaged the anterior cerebral artery and hypothalamus, caused cerebrospinal rhinorrhea and intracranial infection. There were venous sinus injuries in the other two cases. After the operation, the three patients had favorable outcome. Conclusions Stab injury of the brain could occur in any part of the skull. Clinical manifestations directly depended on the damaged structure of the brain. Cerebrospinal fluid leakage, intracranial infection and other complications may happen. On the condition of fully preoperative preparation, the arteries and veins sinus injuries should be appropriately treated during operation.