Toyama Yoshihiro, Kobayashi Takuya, Nishiyama Yoshihiro, Satoh Katashi, Ohkawa Motoomi, Seki Keisuke
Department of Clinical Radiology, Faculty of Medicine, Kagawa University, Japan.
Radiat Med. 2005 Aug;23(5):309-16.
Brain damage after head injury can be classified by its time course. Primary damage that includes acute subdural hematoma (SDH), acute epidural hematoma (EDH), and intraaxial lesions that include contusions, diffuse axonal injury (DAI), and intracranial hemorrhage (ICH), occurs at the moment of impact and is thought to be irreversible. Secondary damage that includes herniations, diffuse cerebral swelling, and secondary infarction and hemorrhage, evolves hours or days after injury as a consequence of systemic or intracranial complications. The duration and severity of secondary damage influence outcome. Head injury management is focused on preventing, detecting, and correcting such secondary damage. CT has been widely used for the neuromonitoring of head trauma. CT is the gold standard for the detection of intracranial abnormalities and is a safe method for survey. While MRI is more sensitive and accurate in diagnosing cerebral pathology, CT is considered the most critical imaging technique for the management of closed head-injured patients in the acute stage. In this article, we review the imaging findings and literature of various lesions of closed head injury in the acute stage.
头部受伤后的脑损伤可根据其时间进程进行分类。原发性损伤包括急性硬膜下血肿（SDH）、急性硬膜外血肿（EDH）以及轴内病变，如挫伤、弥漫性轴索损伤（DAI）和颅内出血（ICH），发生于撞击瞬间，被认为是不可逆的。继发性损伤包括脑疝、弥漫性脑肿胀以及继发性梗死和出血，在受伤数小时或数天后因全身或颅内并发症而进展。继发性损伤的持续时间和严重程度会影响预后。头部损伤的管理重点在于预防、检测和纠正此类继发性损伤。CT已广泛用于头部创伤的神经监测。CT是检测颅内异常的金标准，也是一种安全的检查方法。虽然MRI在诊断脑部病变方面更敏感、准确，但CT被认为是急性闭合性头部受伤患者管理中最关键的成像技术。在本文中，我们回顾了急性闭合性头部损伤各种病变的影像学表现及相关文献。
