Long Lian-sheng, Jiang Ji-yao
Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Chin J Traumatol. 2003 Aug;6(4):226-8.
To explore prospectively the relationship between the state of perimesencephalic cistern and the degree of deformation of the midbrain on CT scanning and the outcome of the patients with acute craniocerebral injury.
The CT scan features including the states of perimesencephalic cisterns, the deformations of the midbrain and the ratios of the occipitofrontal diameter and the transverse diameter of the midbrain of 132 cases were measured. The GOS of the patients 3 months after trauma were regarded as outcome.
The rate of unfavorable outcome (dead, vegetative status, severe disability) was significantly correlated with perimesencephalic cistern narrower than 1 mm (P<0.05), especially narrower than 0.5 mm (P<0.005), deformed midbrain (P<0.005) or abnormal ratio (<0.9 or >1.1) of the occipitofrontal diameter and transverse diameter of the midbrain (P<0.01). But the patient's perimesencephalic cistern wider than 1mm and the patients without deformed midbrain got favorable outcome (moderate disability/good recovery).
The state of the compressed perimesencephalic cistern (<1 mm) and the deformation of the midbrain may significantly indicate unfavorable outcome of the patients with acute craniocerebral injury.
前瞻性探讨CT扫描时中脑周围脑池状态及中脑变形程度与急性颅脑损伤患者预后的关系。
测量132例患者的CT扫描特征,包括中脑周围脑池状态、中脑变形情况以及中脑枕额径与横径的比值。将伤后3个月患者的格拉斯哥预后评分(GOS)作为预后指标。
预后不良(死亡、植物状态、重度残疾)发生率与中脑周围脑池宽度小于1mm(P<0.05),尤其是小于0.5mm(P<0.005)、中脑变形(P<0.005)或中脑枕额径与横径比值异常(<0.9或>1.1)(P<0.01)显著相关。但中脑周围脑池宽度大于1mm且中脑无变形的患者预后良好(中度残疾/恢复良好)。
中脑周围脑池受压状态(<1mm)及中脑变形可能显著提示急性颅脑损伤患者预后不良。