颅脑外伤合并视神经损伤的早期诊断探讨  

Early Diagnostic Discussion on Craniocerebral Trauma Combined with Optic Nerve Injury

作　　者：徐文俊[1] 乔振才[1] 王荣[1] 荣效国[1] 杨杰[1] 徐凯[1] 

机构地区：[1]武警江苏总队医院神经外科,江苏扬州225003

出　　处：《临床军医杂志》2003年第6期64-65,共2页Clinical Journal of Medical Officers

摘　　要：目的　探讨颅脑外伤合并视神经损伤的早期诊断。方法　回顾性分析 3 8例病人首次CT扫描影像临床表现及瞳孔变化资料 ,总结颅脑损伤并视神经损伤的早期特征。结果　视神经损伤瞳孔及CT早期征象 :( 1 )散大侧瞳孔直接光反射消失 ,间接光反射存在 ( 3 0 /3 8) ;( 2 )患侧瞳孔散大 ,直、间接光反射均消失 ,排除脑疝及动眼神经损伤 ( 5 /3 8) ;( 3 )CT示视神经挫伤扭曲变形或血肿压迫视神经 ( 2 /3 8)。结论　根据颅脑外伤病人的早期瞳孔变化及CT征象能显著提高视神经损伤的早期诊断率。Objective To discuss the early diagnosis of craniocerebral trauma combined with optic nerve injury. Methods The early characteristics of craniocerebral trauma combined with optic nerve injury were summed up through retrospectively analyzing the first images of computerized tomography (CT) and the records of the pupils on 38 patients with the disorder. Results The early signs of CT image and the pupil records were as followings. (1) Direct light reflex of the enlarged pupil disappeared, while indirect light of the same pupil did not (30/38). (2) Both the direct and indirect light reflex of the enlarged pupil, and the injuries of cerebral hernia and oculomotor nerve were excluded (5/38). (3) Contusion and twist of optic nerve, as well as compression of hematoma to it, were found under CT (2/38). Conclusion The early diagnostic rate of the injury of optic nerve can be increased according to the early changes of pupils and the CT signs of the patients with craniocerebral trauma.

关 键 词：颅脑外伤 视神经损伤 诊断 瞳孔变化 X线计算机断层扫描 

分 类 号：R651.1[医药卫生—外科学] R774.6[医药卫生—临床医学]