小儿外伤性脑梗塞CT征象及相关研究

Study of Traumatic Brain Infarction if Children with CT features and Clinical Manifestations

目的 通过小儿外伤性脑梗塞的CT征象及临床表现,研究小儿外伤性脑梗塞的病理机制、分型和预后的关系。方法 收集1992年12月至2002年10月经CT扫描确诊为小儿脑梗塞27例作为研究对象,全部病例均有明确的外伤病史。结果(1)小儿外伤性脑梗塞与成人脑梗塞不同,病史轻,CT征象及临床症状明显。(2)单纯型预后良好,混合型预后较差。(3)病理机制除血管解剖因素、潜在性血管疾病及内分泌所致血管病变外,作者提出产前缺氧及产后缺血缺氧性脑病的患儿为本病的高发对象。结论 梗塞灶大小和有否合併脑内挫裂伤，脑萎缩、脑发育不良与该病预后关系密切，CT检查是诊断本病的主要手段。

objective To study the pathogenesis,classification andprognosis of traumatic brain infarction on the basis of its CTfeatures and clinical manifestations. Methods The CT features of27 children with traumatic brain iffarction were retrospectivelystudied. Results (1)The clinical manifestations of traumatic braininfarction in children were different from those in adults.Aslight injury would result in serious CT features and clinicalmanifestations.(2) The prognosis was favorable in simple type oftrauma but quite serious in mixed type of injury.(3)The patho-genesis of traumatic brain infarction was quite complicated.Itmay involve the insidious or endocrine-induced pathology ofblood vessels.The authors suggest that a child who has sufferedfrom prenatal anoxia or postnatal ischemic or anoxic encephal-opathy is more liable to develop severe manifestations of trau-matic brain infarction. Conclusion If combined contusion andlaceration of brain、encephalatrophy、atelencephalia or not,andthe field of infarction relate to the prognosis of disease.ctexamination is an important method for diagnosis.[