南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (03): 359-360.

• • 上一篇    

外伤性大脑纵裂血肿31例临床分析

柯以铨1, 李钢1, 张庆国2, 雷洪伊2   

  1. 1. 第一军医大学珠江医院神经外科, 广东, 广州, 510282;
    2. 第一军医大学珠江医院麻醉科, 广东, 广州, 510282
  • 出版日期:2004-03-20 发布日期:2004-03-20
  • 基金资助:
    收稿日期:2003-9-19。
    作者简介:柯以铨(1963- ),男,1984年毕业于第一军医大学,副教授,副主任医师,硕士生导师,电话:020-61643266,E-mail:keyiquan@hotmail.com

Clinical analysis of 31 cases of traumatic interhemispheric subdural hematomas

KE Yi-quan1, LI Gang1, ZHANG Qing-guo2, LEI Hong-yi2   

  1. 1. 第一军医大学珠江医院神经外科, 广东, 广州, 510282;
    2. 第一军医大学珠江医院麻醉科, 广东, 广州, 510282
  • Online:2004-03-20 Published:2004-03-20

摘要: 目的 探讨大脑间纵裂血肿的发生机制、临床表现和治疗方法。方法 回顾性分析1996年以来收治的31例外伤性大脑间纵裂血肿患者的临床特点和救治情况。结果 本组治愈29例,2例患者分别死于多脏器功能衰竭和晚期脑疝。大脑纵裂血肿患者受伤初期意识障碍不严重,其典型表现为对侧下肢单瘫或偏瘫,下肢重于上肢,称之为大脑镰综合症。结论 在大脑纵裂间积血达20 ml以上或出血厚度超过1 cm,可以作为大脑间纵裂血肿诊断的一个参考标准。治疗方法包括保守治疗和手术治疗,手术治疗多以功能障碍或病情稳定与否来考虑选择手术的依据。

Abstract: Objective To analyze the clinical characteristics, pathogenesis and management of traumatic interhemispheric subdural hematomas (ISH). Methods Thirty-one traumatic ISH cases were reviewed and analyzed retrospectively. Results Of the 31 patients, 29 were cured and 2 died of multi-system organ failure (MSOF) and cerebral hernia respectively. Typically, ISH manifested hemiplegia or paralysis of the counterlateral lower limb known as falx syndrome. Conclusions CT scans showing hematocele in the interhemispheric subdural space in excess of 20 ml, or with a thickness of hematocele over 1cm, may serve as a diagnostic criteria for ISH. For the treatment of ISH, surgery and conservative management are suggested on the basis of functional disturbance or the stability of the disease.

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