《中国康复理论与实践》

《中国康复理论与实践》 ›› 2013, Vol. 19 ›› Issue (1): 74-76.

• 论文 • 上一篇    下一篇

儿童创伤性大面积脑梗死的临床特征

黎开谷，梁平，李映良，翟瑄，夏佐中，周渝冬，李禄生   

  1. 重庆医科大学附属儿童医院神经外科，重庆市400014。
  • 收稿日期:2012-06-15 修回日期:2012-08-17 出版日期:2013-01-25 发布日期:2013-01-25
  • 通讯作者: 梁平

Posttraumatic Cerebral Massive Infarction in Children: 68 Cases Report

LI Kai-gu, LIANG Ping, LI Ying-liang, et al   

  1. Department of Neurosurgery, Children Hospital of Chongqing Medical University，Chongqing 400014, China
  • Received:2012-06-15 Revised:2012-08-17 Published:2013-01-25 Online:2013-01-25

PDF (PC)

被引次数

9

摘要： 目的探讨儿童颅脑创伤性大面积脑梗死的临床特点。方法对68 例颅脑创伤性大面积脑梗死患儿进行回顾性分析。结果本组病例硬膜下出血最多(43.6%)，其次是硬膜外出血(23.5%)和脑出血(20.6%)，平均出血量65 ml；并发脑挫裂伤37例，蛛网膜下腔出血43 例，颅骨骨折48 例；四肢骨折24 例，胸腹部脏器损伤15 例，失血性休克30 例。梗死发现时间主要在伤后1 周内，其中4~7 d 是发病高峰(32 例)。根据格拉斯哥预后评分标准，恢复良好32 例，轻度残疾15 例，重度残疾9 例，植物生存4例，死亡8 例。结论儿童颅脑外伤性大面积脑梗死发病隐匿，CT 或MRI 是诊断的主要手段。及早发现，积极治疗，预后较成人良好。

关键词: 颅脑损伤, 大面积脑梗死, 颅内出血, 儿童

Abstract: Objective To explore the clinical characteristics of posttraumatic cerebral massive infarction in children. Methods 68 cases were reviewed. Results There were 43 cases complicated with subarachnoid hemorrhage, 37 with brain contusion, 48 with fracture of skull,and the hematoma was subdural in 29 cases, epidural in 16 cases, and intracerebral in 14 cases. Other complications included fracture of limbs (24/68), thoracic or abdominal injury (15/68), and hemorrhagic shock (30/68). The infarction were found mostly in the first 7 d (range 2 h~13 d), and 32 cases within 4~7 d after the trauma. The outcome when discharged (according to the Glasgow outcome scale) was good recovery in 32 cases, moderate disability in 15 cases, severe disability in 9 cases, vegetative state in 4 cases, and 8 cases died. Conclusion The feature of the posttraumatic cerebral massive infarction in children is usually concealed by primary injury. CT and MRI are the bases for diagnosis.The outcome may be better than in the adults when early diagnosis and intervention has been produced.

Key words: brain traumatic injury, massive cerebral infarction, intracranial hematoma, children