外伤性基底节区血肿42例临床分析

Clinical analysis of traumatic basal ganglial hematomas in 42 patients

目的 研究外伤性基底节区血肿 ( TBGH)的发病机制、临床特点及预后因素。方法 回顾分析了42例 TBGH病人的临床资料。结果 TBGH常见于车祸所致的减速性损伤 ,血肿多位于受力对侧 ;伤后早期出现偏瘫而意识障碍相对较轻为临床特征 ;年龄 >60岁 ,原发性脑损伤重 ,血肿量 >3 0 m L ,瞳孔异常 ,GCS评分 <8分者死亡率高。结论 中间脑挫伤概念可解释 TBGH形成 ;其临床表现具有特点 ,正确认识该病 ,动态 CT可明确诊断 ;原发性脑损伤程度、年龄、瞳孔变化、血肿量。

Objective To study the pathogenesis,clinical characteristics and prognostic factors of traumatic basal ganglial hematoma (TBGH).Method Clinical data of 42 patients with TBGH were analyzed retrospectively.Results TBGH often occurred on decelerative injury with traffic accident.It located most frequently in the contralateral side of impact.Early hemiplegia and relatively good consciousness after injury are of its clinical features.High mortality was usually seen in the patients over sixty,who suffered from severe primary brain injury (GCS<8),or whose hematoma larger than 30 mL and abnormal pupil occurred.Conclusion The concept of intermediary brain contusion can interpret the mechanism of formation of TBGH.TBGH has its distinct clinical characteristics.Serial CT scans may be helpful to making early diagnosis.The age of patients,severity of brain injury,pupillary changes,size of hematoma and the level of consciousness were the main factors influencing the prognosis of the patients with TBGH.