动态CT扫描联合TCD检查预测外伤性蛛网膜下腔出血患者预后

目的动态CT扫描联合TCD预测外伤性蛛网膜下腔出血（tSAH）患者预后。方法对155例外伤性蛛网膜下腔出血患者给予动态CT扫描及TCD监测脑血流，6个月后行GOS评分（预后评分）。结果CT扫描tSAH出血量多、Hidjra分型13分以上、出血部位位于颅底大血管周围（外侧裂池、基底池、鞍上池、环池、四叠体池），合并明显颅内损伤，颅内压较高及TCD监测的大脑中动脉血流明显增快者GOS评分低，预后较差。结论tSAH患者动态CT表现严重、TCD血流增速明显者，预后差。

Evaluation of neurological outcome in traumatic subarachnoid hemorrhage with dynamic CT scan and TCD monitor

Objective To evaluate the neurological outcome in traumatic subarachnoid haemorrhage with dynamic CT scan and TCD monitor. Methods 155 patienls with traumatic subarachnoid haemorrhage underwent dynamic CT scan associating with TCD monitor and GOS （Glasgow Outcome Scale） prognosis assessment afer 6 months. Results The GOS prognosis was poor in patients with more hemorrhage, higher than 13 points according to Hidjra＇s classification; hemorrhage located around the large vessels of skull base such as fissured cistern, basilar cistern, suprasellar cistern, ambient cistern, quadrigeminal cistern, with serious intracranial injury; with higher intracranial hypertension and higher TCD velocity. Condusion Patients with traumatic SAH associating with more severe dynamic CT findings and higher TCD velocity had a worse outcome.