儿童创伤性大面积脑梗死的临床特征  

Posttraumatic Cerebral Massive Infarction in Children: 68 Cases Report

作　　者：黎开谷[1] 梁平[1] 李映良[1] 翟瑄[1] 夏佐中[1] 周渝冬[1] 李禄生[1] 

机构地区：[1]重庆医科大学附属儿童医院神经外科,重庆市400014

出　　处：《中国康复理论与实践》2013年第1期74-76,共3页Chinese Journal of Rehabilitation Theory and Practice

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65ml；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4～7d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。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 re- covery 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 di- agnosis. The outcome may be better than in the adults when early diagnosis and intervention has been produced.

关 键 词：颅脑损伤 大面积脑梗死 颅内出血 儿童 

分 类 号：R651.1[医药卫生—外科学]