双额叶脑挫裂伤并发脑中心疝的临床分析

Clinical analysis on bilateral frontal lobe contusion and laceration with central brain herniation

目的探讨双额叶脑挫裂伤及并发脑中心疝的临床特点,手术时机和方法。方法回顾性分析23例双额叶脑挫裂伤并发脑中心疝患者的临床症状、影像学特征、治疗方法及治疗效果。结果半年随访,根据格拉斯哥预后评分(GOS评分),恢复良好7例,中残7例,重残5例,植物生存2例,死亡2例。结论双额叶脑挫裂伤患者应密切观察意识,瞳孔,CT影像学变化,及时的双侧开颅减压,以提高治疗效果。

Objective To investigate the clinical characteristics, operation timing and methods of bilateral frontal lobes contusion and laceration with central brain herniation. Methods The clinical characteristics, imaging characteristics, treatment methods and effects of 23 patients of bilateral frontal lobes contusion and laceration with central brain herniation were analyzed retrospectively. Results All patients were followed up half a year. According to GOS classification, of 23 patients, 7 were recovered well, 7 moderately disabled, 5 severely disabled, 2 vegetatively survived and 2 died. Conclusions The dynamical changes should be closely monitored and more attention should be of consciouseness, pupil and CT imaging paid to the patients with bilateral frontal lobes contusion and laceration. Timely bilateral craniotomy operation can improve the curative effect.