外伤性脑梗塞的分型及CT表现

Traumatic cerebral infarction—classification and CT manifestation

目的 探讨外伤性脑梗塞的分型及CT表现。方法 分析46例外伤性脑梗塞的临床特点与CT表现。结果 根据其临床特点和CT表现将其分为2型即Ⅰ型(24例),轻微外伤型;Ⅱ型(22例),严重外伤型。Ⅰ型见于小儿,特别是婴儿,外伤轻微,CT表现为基底节区腔隙性梗塞灶,79.2％(19/24)双侧豆状核见点状钙化灶。Ⅱ型多见于成人,小儿少见,有严重的颅脑损伤,CT表现为基底节区或和脑叶梗塞及颅脑损伤的征象,如颅内血肿、脑水肿及挫伤等。结论 CT对外伤性脑梗塞有很大的诊断价值,两型可能有不同的发生机制,Ⅰ型主要是潜在性血管病变及钙化致血管痉挛所致,Ⅱ型主要与血管的损伤和受压有关。

Objective To study the CT manifestactions and classification of traumatic cerebral infarction (TCI). Methods 46 cases of TCI were reviewed and analysed retrospectively. Results According to their differential clinical features and CT manifestations of TCI, which were classified as 2 types: type Ⅰ, minor head injury and type Ⅱ, severe head injury. Type Ⅰ(24 eases) occurred in children, especial in infants, cerebral lacunar infarctions in basal ganglia after a minor head injury were viewed in CT. In 19 cases79.2%), spotty calcifications were found in the lendform nucleus. Type Ⅱ(22 cases)occurred in adults or children after a severe head injury, cerebral infarctions of basal ganalia or and brain lobe, and usually complicated with intracranial hematomas, cerebral edema or contusion were viewed. Conclusions CT is very useful in the diagnosis of TCI.2 types of TCI may have differential mechanisms, type Ⅰ mainly refer to potentional vascular disease and vasospasm, type Ⅱ refer to severe vascular injury and compression.