“轻型颅脑损伤”早期突然死亡原因分析  

Etiological analysis of sudden death following early mild head injury

作　　者：环一雷[1] 李震[1] 潘恩裕[1] 张智民[1] 

机构地区：[1]靖江市人民医院神经外科,江苏靖江214500

出　　处：《中华神经医学杂志》2003年第5期372-373,共2页Chinese Journal of Neuromedicine

摘　　要：目的 分析3例颅脑损伤后有中间好转期的病人,入院时神志清楚,头颅CT未见颅内血肿,住院数小时内突然死亡的原因。方法 对3例病人的伤情、治疗及死亡经过进行总结。结果 3例死亡原因可能是颅脑剪应力损伤引起的血管舒缩运动中枢损伤。多为脑底动脉环受刺激,血管舒缩麻痹出现的特急性全脑缺血,或颅颈交界处损伤引起的上颈髓和延脑损伤。结论 在有旋转性损伤的轻型病例中,应特别注意很少发生的突发性猝死情况。为了挽救病人生命和防范医疗纠纷,要重视全面体检和辅助检查,特别是颅颈交界处损伤的检出,做好颅脑损伤患者低血压的升压治疗及呼吸的复苏,降低死亡率。Objective To discuss 3 cases of head injury with interval lucid, who were conscious at admission and revealed no intracranial hematoma on initial CT scan, but died in several hours. Methods The severity, therapies and the process of death of these 3 cases were analyzed and concluded. Results From the case records, we concluded the death of the three cases was produced in two ways as follows: one was most probably caused by shearing force leading to vasomotor centre and stimulation to arterial circle, which resulted in paralysis of vasomotor and consequentially led to acute ischemia of whole brain; the second was the injury on the craniocervical junction and caused damage to medullar oblongata or superior cervical spinal cord. Conclusion In mild rotating head injury cases, we should pay attention to sudden deaths although they are uncommon. In order to save patients life and avoid hospital-patient disputes, we should give thorough physical and accessory examination to these kinds of patients, especially those with head-neck junction injury, and make preparation for normalizing blood pressure and respiratory resuscitation to reduce mortality.

关 键 词：轻型颅脑损伤 早期 突然死亡 原因 突发性猝死 

分 类 号：R651.15[医药卫生—外科学] R541[医药卫生—临床医学]