重型颅脑损伤继发外伤性癫103例临床分析

Cinical analysis of 103 cases of posttraumatic epilepsy after severe traumatic brain injury

目的分析重型颅脑损伤继发外伤性癫形成的原因、发病机制,以及外伤性癫的预防措施。方法对重型颅脑损伤患者救治过程中继发外伤性癫的临床特点和治疗结果进行回顾分析。结果 946例重型颅脑损伤病人继发性癫103例,发生率10.9%。其中颅骨凹陷粉碎性骨折39例(37.9%),开放性颅脑损伤28例(27.2%),颅内血肿25例(24.3%),单纯脑挫裂伤11例(10.7%)。结论重型颅脑损伤继发外伤性癫是局部严重的脑神经细胞结构损伤和神经抑制、负反馈系统破坏,导致神经细胞异常过度放电和异常放电进一步扩展形成的。

Objective To analyze the etiology pathogenesis and precautions of posttraumatic epilepsy after severe traumatic brain injury. Methods The clinical manifestations and treatments were studied in patients with .posttraumatic epilepsy after severe traumatic brain injury. Results Totally 103 patients with posttraumatic epilepsy from 946 patients with severe traumatic brain injury, the incidence was 10.9%, 39 patients with comminuted and depressed fracture of skull, 28 Patients with open craniocerebral injury, 25 patients with intracranialhematoma, 11 patients with simple cerebral contusion. Posttraumatic epilepsy after severe traumatic brain injury was caused by neural cell structures damaged. Conclusion Posttraumatic epilepsy after severe traumatic brain injury is caused by anomaly excessive and abnormal excess firings of neural cell with structures damaged, and neural inhibition and negative feedback central system damaged.