颅脑减速伤的损伤特点研究

目的研究颅脑减速伤的损伤特点,探讨其在颅脑创伤的伤情判断和影像诊断中的应用价值。方法分析361例临床典型颅脑减速伤患者的颅脑CT影像资料,结合致伤病史及临床资料,总结归纳颅脑减速伤的损伤特点。结果颅脑减速伤损伤的主要特点为:撞击部位头皮损伤、颅盖骨折、硬膜外血肿、硬膜下血肿和脑挫裂伤,对冲部位硬膜下血肿、颅底骨折和脑挫裂伤;颅骨骨折以撞击部位多见,硬膜下血肿以对冲部位多见,蛛网膜下腔出血主要位于脑底部及脑挫裂伤区;额、颞叶严重对冲伤是常见颅脑减速伤的重要特征。结论根据颅脑减速伤的损伤特点,结合致伤病史或颅脑CT表现,可为临床颅脑减速伤伤情的快速判断与救治、CT扫描及诊断、创伤事故原因的评判提供理论依据。

Study on the injury characteristics of head deceleration injury

Objective To study the injury characteristics of head deceleration injury（ HDI ）, and discuss its value in severity judgment and imaging diagnosis for HDI patients. Methods The data on the head CT imaging, history of head impact and clinical record were analyzed, and the injury characteristics of HDI were summarized. Results The main injury characteristics of HDI were as follows： scalp contusion, cranial fracture, epidural hemato- ma, subdural hematoma and cerebral contusion at impact position; subdural hematoma, basal fracture and cerebral contusion at contrecoup site;skull fracture mainly at impact position, subdural hematoma mainly at contrecoup site, subarachnoid hemorrhage mainly at the base of brain and cerebral contusion regions ; severe eontrecoup injury at fron- tal and temporal lobe. Conclusion Analyzing the HDI characteristics, combined with the history of head impact or the head CT findings, can help to provide the theoretical clinical evidence for rapid judgment, therapy, CT scanning and diagnosis of HDI,and judgment of head accident causes.