迟发性脑挫裂伤的CT表现及复诊时间

CT manifestations and reexamination time of delayed contusion and laceration of brain

目的:探讨迟发性脑挫裂伤的CT表现及复诊时间。方法:回顾分析152例经2次以上CT检查证实的迟发性脑挫裂伤的CT首诊时间、首诊CT表现、CT首次检出脑挫裂伤的时间及表现。结果:伤后24小时内复查CT共检出迟发性脑挫裂伤88例,占57.9%;首诊CT发现伴蛛网膜下腔出血和广泛脑水肿的31例中,27例日后形成重型或极重型迟发性脑挫裂伤。结论:头部外伤后,应于伤后24小时内复查头部CT,以尽早明确有无迟发性脑挫裂伤。对临床累计昏迷超过30分钟,首诊CT呈现伴有蛛网膜下腔出血的广泛脑水肿者尤应密切随诊。

Objective: To discuss the CT manifestations and reexamination time of delayed contusion and laceration of brain(DCLB). Methods: The initial CT examination and the initial CT appearance of DCLB in 152 cases proved by more than two consecutive CT scans were reviewed. Results: In 152 cases of DCLB, 88(57.9%) cases were first found within 24 hours after injury on CT images. Twenty-seven of 31 cases suffering from subarachnoid hemorrhage and extensive encephalo-edema on the first CT examination finally deteriorated into severe or utmost severe DCLB. Conclusion: In order to find out DCLB in time, CT reexamination should be taken within 24 hours after head trauma, particularly for the patients whose adding up coma stage lasts more than thirty minutes and subarachnoid hemorrhage and extensive encephalo-edema were found on the initial CT image.