56例脑弥漫性轴索损伤的临床分析

Clinical analysis of 56 cases of diffuse axonal injury

目的 探讨脑弥漫性轴索损伤 (DAI)与脑挫裂伤、原发性脑干伤和脑震荡的关系。方法 分析 5 6例DAI病人的临床资料和影像学特点 ,与原发性脑损伤的特征进行比较。结果 5 6例DAI伤者中 6 6 %为交通伤 ,多次暴力致伤比较常见 (6 1% )。伴脑挫裂伤者 40例 (71% )。CT MRI发现出血灶者 45例。 结论 DAI是常见的弥漫性脑损伤 ,脑震荡和原发脑干伤被包含其中 ,且常常与脑皮质挫裂伤伴发。将原发性脑损伤分为局限性和弥漫性损伤两大类似乎更为简单实用。

Objective To analyze the mechanism of diffuse axonal injury (DAI) and study the relationship between DAI and primary brain injuries including concussion, contusion, laceration and brain stem injury. Methods The clinical data and iconographic characteristics of 56 patients with DAI were analyzed retrospectively. Results Traffic accidents were the main cause (66%). Among the cases, 34 were injured for at least twice, and 71% of the patients were complicated with contusion and laceration. Conclusions It is considered that DAI is a common and primary brain injury, which is often underestimated, and DAI includes cerebral concussion and primary brain stem injury and often complicated with cerebral cortex contusion. Therefore, it is very simple and practical to divide primary brain injuries into localized and diffused ones.