脑弥漫性轴索损伤

The diffuse axonal injury of brain

报告48例脑弥漫性轴索损伤(DAI),占同期重型脑外伤的11.9%;病例选择是根据外伤机理,有原发昏迷,无定侧体征;详细分析了 CT 扫描的特征。讨论了 DAI 的分类及诊断条件,本组死亡率为64%,是重型脑外伤死亡的主要原因。对于 DAI 伴有脑挫伤、脑实质血肿并有中线移位者,手术去除血肿及去骨减压,可挽救部分病人生命,其治疗后果取决于 DAI 的严重程度。

Fourty-eight patient with diffuse axonal injury(DAI)are reviewed.It composed 11.9% of allsevere head injury.Most of the patients were causedby trafic accidents.There were 37 males and 11 females.The selection of patients was depended onthe mechanism of trauma,loss consciousness onimpact,no localized neurological signs andfinding of CT scan.Axial computerized tomographywas performed on all patients in 24 hours afterinjury and it demonstrated a less or no shift ofmidline,with partial or total disappearance ofbasal cisterns and third ventricle.It might becoexistence of contusion or hemorrhage in the whitematter but without large hematoma,The pathologicnature,classification and treatment of DAI arediscussed.DAI has a high mortality rate(64%)andmorbidity,especially when it associated withsubdural,intracerebral or ventricular hemorrhage.If DAI complicated with intracranial hematoma,orshift of midline structure appearedon the CT scansurgical treatment should be perfomed immediatelyand intensive care for intracranial hypertention maybe the adequate in some cases.