1、额叶挫裂伤致脑中心疝 31 例临床分析?z?1002-0179(2007)04-0706-02?O?,?n?.?31?w?-?ClinicalAnalyzeofBrainCentralHerniaCausedbyFrontalLobesContusionandLaceration?1,?13,?J?2,?o?2,?1,?1,?1,?L?3YANGYong-bo1,HUANGYu-jie1,YOUChao2,etal.(11,?D?210008;21,?i?D?610041;31;?D?242000)(11DepartmentofNeurosurgery,DrumTowerHospital,Me
2、dicalSchool,NanjingUniversity,NanjingJiangsu210008,China;21DepartmentofNeurosurgery,WestChinaHospital,SichuanUniversity,ChengduSichuan610041,China;31DepartmentofNeurosurgery,XuanchengHospital,XuanchengAnhui,242000,China)D?D?:?:?O?,?n?.?w?C?,?(?(?D?:?G?-?31?O?,?n?.?2?w?D?D?,?9?z?/?O?,?n?.?D?D?:?U?l?;
3、16?:?4?,?12?D?G?C?;8?,?V?X?D?7?D?V?X?D?:?O?,?,?;?O?,?2?s?n?G?-?X?n?.?,?CT?G?X?n?D?(?n?D?)?D?D?,?n?s?;?8?sD?8?:?n?.?G?;?O?,;?n?s;?;?.?-?R65112D?D?D?8?7?AAbstract:Objective:ToInvestigatetheclinicalandimagingcharactersofcontusionandlacerationoffrontallobeofbrainandselecttheefiecfivetreatment.Methods:Th
4、echaracterof31centralherniasofbraincausedbyfrontallobescontusionandlac2erationwereretrospectivelyanalyzedandtheirclinicalsignsandsymptcms,imagingfindingsandtreatmentmethodswerediscussedincombinationwithreviewsofdomesticandabroadliteratures.Results:Theresultsof16caseswhoacceptedoperationwhenthepupila
5、contractedwerethat4casesdiedorseveredeformities,12caseshavingmoderatedeformitiesorbeingwell.Theresultof8caseswhoacceptedoperationwhenthepupildilatedwasdeadorseriouslymorbid.Theresultsof7casesacceptedconservativetreatmentwasdeadinorseriousmorbility.Conclusion:Mostbrainherniacausedbyfrontallobescontus
6、ionandlacerationwascentralhernia,especiallybilateralfrontallobescontusionandlaceration.ThecharactersinCTimageofthisherniawasthatlateralventricle,thirdventricle,basilarcistern,ambientcisternandcorporaquardrigeminacisternwascompressedanddeformed.Di2encephalonsperiodwasthekeyperiodforsalvage.Keywords:b
7、raincentralhernia;frontalLocuscontusionandlaceration;Diencephalonsperiod;operation;pupil(Receiveddate:2007-07-10)?1.?n?.?Plum?-?s?J?G?l?0?w?R?0?-?0?n?J?z?-?l?J?U?l?J?J?-?0?z?P?X?.?n-?n?)?.?%?J?J?p?n?X?n?-?)?p?1?J?J?p?p?r?a?z?(?4?p?1?J?G?p?p?r?aD?2?(3),?v,?e?,?:?:?9,?:?DD?3,?f?X,?C?D?.?j?;?y?n?.?,?E?
8、p?C?J?D?G?w?3?6,?J?,?z?nD?h?/?G?:?/?a?:?G?:?5?O?,?n?41?(?O?,28?,?O?,13?),?N?9?n?.?31?(7516%),?:?4:1D?w?/?111D?h?/?:?:?31?,?v?G22?,?G9?D?14?80?,?V3913?D?.?O?,21?,?O?,10?D112D?w?:31?g?z?C?/?U?l,?0?V?g,?w?R?0?V?JD?g?U?l?l?10?,?(?l?21?,(?10?,?l?8?,?.?l?3?);?l?J?;?z?-?0?T?G?,?q?p?6?D13D?/?g?U?l?3?w?T?I?X
9、?X?z?n?U?l,?C?I?D?W?120?;?D?)?,?-?z?pD?(?n?l?E?j?pD?D?D?O?,?.?,?B?G?lcm,?E?O?,?.?D5?g?G?C?3?w?T?I?X?)?z?z,?(?n?D?z?pD607WESTCHINAMEDICALJOURNAL2007,Vo1122,No14D?CN51-1356/R?8:197-11911:17C:C:114D?:?h?;24?,?7?D?;?V?z/?z?;D?g?p?wD?d?J?D2D?;?C?6?18?j?9,?(?)?gJennett?Bond?5?-?w?D?:211D?;24?:?U?l?;16?:b?
10、:1?(1/16,6125%),b?1?(1/16,6125%),b?1?(1/16,6125%),b?4?(4/16,25%),b?9?(9/16,56125%)D?G?C?;8?:b?:7?(7/8,8715%),b?1?(1/8,1215%),212D?7?:b?:6?(6/7,8517%),b?1?(1/7,1413%)D?/JennettBond?C?-?:b?(?),b?(?3?s?D?s?l?,?g?z?n?X?),b?(?,?),b?(?.?,?s?:?-),V?(?,?i?,?s?p?)D3D?n?.?;?7?)?n?.?,?2?o?nD?D?(?n?D?o?n?4?,?n?
11、,?n?4?D?,?p?s?w?(?G?z?9?D?h?/?I?X?O?,?9?n?2?G?-?n?.?,?7516%,?.?O?,?7619%,?O?,6717%D?n?X?O?,?O?;?O?,?n?n?.?X?:D?X?3?6?,?k?,?3?a?n?l?n?7?,?6?;?n?.?i?,?n?.?,?n?.?n?4?,?i?n?.?1D?n?.?3?6?G?,?(?w?DPlum?W?l?D?JD?R?1?D?D?-?n?.?-?X?s:?n?s,?.?n?s-?n?)?s,?n?-?)?s,?sD?1D?n?s?;?,?n?.?2?8?s,?s?n?G?n?3?,?D?S?w?3?,
12、?)?n?,?GD?0?p,?C?(?s,?D?n?n?s?,?h?U?l?C?j?g?j?;?3?n?s?X15?15?l?,?V1-?s?q-?d?(?,?I?n?s?,?X?5?;?M?D?h?28?g?n?s?g?o?m?-?s?q-?d?(?,?z?,?.?j?;4?n?s?X215?5?l?,?V318?l?D?g?n?s?5?;?2?C?G?gD?h?n?s?;16?1?,?G?B?(12?)?s?:?-?B?J?s?:D?6?C?(?s8?;?,?7?,?1?3?s?D?;?l?-?X?z?,?z?9?gD?n?n?s?;?.?2?n?O?,?C,?n?l?,?C?I?4?,?
13、n?D?h?3?6?;,?E?C?(?s?;?p?n?Y?,?;?.?n?l?,?n?C?I,?n?g?D?,?6?z?;D?,?;?N?0?n?.?n?s?D?(?D?B?h?,?n?,?/?U?l,?0?g,?w?R?0?J,?s?n?.?D?C?w?J?)?GD?0?p?X?n?7?;?3?6?DBrodalA,JulianRY,LambJF?X?g?n?s?o?n?z?J?-?9?D?p?6?-?0D?p?P?o?n?p?n?1?6?-?l?JD?E?;?.?nD?n?j?,?k?l?3?B?j?2,3D?W?w?l?D?-?0?-?l?J,?f?;?n?.?sD?h?9013%?z?
14、l?(?l?),29%?/?-?0?T?GD3415%?-?l?JD?O?R?l?;,?h?/?I?X?-?n?.?(5116%)?g?n?s?q?p?D?p?n?s,?G?n?P?p?;?gD?s?d?G?q?p?D?,?n?X?,?q?p?,?n?.?sD?n?-?h?3?w?CT?C,?X?n?.?)?(?4?:,?g?n?s?p?n,?:?n?(?n?X?:,?6?C?n?(?D?B?j?;:?z?n?C?I?,?n?W?,?B?D?O?,?.?,?B?G?,?E?O?l?O?,?,?p?g?,?.?3?C?ID?)?,?-?z?pD?(?n?D?C?n?R,?E?K?(?n?4,5D
15、,?C?(?s?n?s?z,?B?(?n?,?X?D?n?h?k?3?D30?V,?E?k?g,?w?J?C?I,?2?k?h?2?w?D?g?s?g?p?w?,?E?U?C,?p?w?C?I?D?n?-?p?k?n?w?,?o?m?p?w?e?D?O?,?0?k?z?n?.,?p?w?C?I?p,?B?y?D?C?k?G?n?k?3?6,?C?2?k?n?w?l,?p?w?O?,?X?D?60?n?k?n?.?2?g?n?s?g?o?m?-?s?q-?d?(?,?j?;,80%?2?6D?G?-?z?:?s?B?O?,?2?s?n?.?h?,?n?.?s?J?S?B?j?D?n?t?O?,?
16、s?g?1?)?k?:?bD?E?V?,?)?:?b?g?C,?n?4?G?,?.?n?(?o?nD?n?)?s?S?X?,?s?y?n?.?D?j?nCT?z?)?,?h?n?.?s?,?nCT?I?X?)?V?g,?E?n?.?s?C?nCT?I?X?)?V?pD?C?w?)?.?n?s?,?)?)?pD4D?1?8:1?.?z?M.?:?e?;?I,1998:65.2BrodalA.Neurologicalanatomyinrelationtoclinicalmedicineed3M.NewYork:xfordUniversityPress,1981:394.3LambJF.EssentialsofphysiologyM.d3.BlackwellScientificPublications,1984:198.4?n,?N?,?s.?w?CCTJ.?w?P?,1995(8)4:235-236.5?K?.?Y?G?n?.?n?.?32?w?-?J.?B?:?,20O0,
