脑室及脑池出血为主的颅脑损伤27例临床分析

Clinical analysis of 27 cases of craniocerebral injury with cerebral ventricle and brain pool hemorrhage

【摘要】目的研究脑室及脑池出血为主的颅脑损伤患者的临床诊断和治疗措施。方法选择脑室及脑池出血为主的颅脑损伤患者27例，综合分析本研究27例患者的影像学资料，充分了解其多排螺旋CT血管造影（CTA）或者数字减影血管造影（DSA）诊断的结果以及有效治疗的方法和疗效。结果本研究24例患者接受DSA或者CTA检查，阳性10例，包括4例颅内动脉瘤、2例多发颅内外血管闭塞或者严重狭窄、3例脑动静脉畸形以及1例烟雾病；余下14例均为阴性患者。27例患者中除1例发生死亡事件外，余下26例都经保守或者手术治疗痊愈出院。随访6个月，1例烟雾患者者发生再出血，而其余患者的预后都比较好，无再出血征象。结论通过对脑室及脑池出血为主的颅脑损伤患者施以常规DSA或者CTA检查，可显著提升其病情诊断的准确性，降低漏诊率。

Objective To study the clinical diagnosis and treatment of craniocerebral injury pa- tients with intraventricular and brain pool hemorrhage. Methods Twenty-seven craniocerebral injury pa- tients with intraventricular and brain pool hemorrhage were selected, the image data were comprehensive- ly analyzed, fully understand the results of the DSA and CTA diagnosis and effective treatment methods and curative effect. Results Among the 27 patients, 24 cases underwent DSA or CTA examination, 10 cases were positive, including 4 cases of intracranial aneurysms, 2 cases of multiple intracranial vascular occlusion or severe stenosis, 3 cases of cerebral arteriovenous malformation, and 1 case of moyamoya dis- ease. The remaining 14 cases were negative. Among the 27 cases, the remaining 26 cases were treated with conservative or surgical treatment. During the 6 months follow-up period, 1 case with smog had re- hemorrhage, while the remaining patients had a better prognosis, without rebleeding signs. Conclusions Routine DSA or CTA examination can significantly improve the accuracy of the diagnosis and reduce the rate of missed diagnosis by applying routine DSA or CTA examination to patients with cer- ebral ventricle and brain pool hemorrhage.