弥漫性轴索损伤在重型脑损伤中的意义  

The significance of diffuse axonal injury in severe head injury.

作　　者：胡小吾[1] 赵孟尧[1] 过宗南[1] 王文仲[1] 周晓平[1] 郝文清[1] 段承祥[1,2] 段承祥[1,2] 刘振华 

机构地区：[1]第二军医大学长海医院神经外科,200433 [2]第二军医大学长海医院CT室 [3]第二军医大学病理解剖教研室

出　　处：《中国神经精神疾病杂志》1993年第6期331-333,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：在15例闭合性脑损伤尸检中,病理诊断弥漫性轴索损伤(DAI)5例。根据病理研究结果和文献报道,分析了530例急性脑外伤病人脑CT表现,发现DAI61例。其CT表现为大脑皮髓质交界处、基底节内囊区域、胼胝体、脑干或小脑有一个或多个直径≤2cm的出血灶,脑室内出血及急性弥漫性脑肿胀。本文把DAI分为高颅压型和非高颅压型,后者又分的脑干损伤型和局灶性损伤型。这种分型对指导治疗和判断预后均有重要意义。DAI预后较差,是目前脑外伤病人死亡率高的重要原因之一。Diffuse axonal injury (DAI),as defined by pathological exmination,was found in 5 out of 15 cases with closed head injury.According to this histopathologic findings and reported paper,we analysised CT signs of 530 cases with acute brain injury and found 61 cases with DAL The CT scans showed that DAI were one or more hemorrhagic lesions less than 2 cm in diameter at corticomedulla,basal gangliainternal capsule,corpus callosum,brain stem or cerebellum,intraventricular hemorrhage and generalized brain swelling.We classified DAI into two types-raised ICP type,and noraised ICP type,the latter was subdivided into brain stem injury type and local injury type.This classification is of importance for treatment and prognosis of DAI.The outcome of DAI is very poor.DAI is one of critical causes of the high mortality from brain injury at present.

关 键 词：颅脑损伤 弥漫性 轴索损伤 CT 

分 类 号：R651.15[医药卫生—外科学]