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[从年龄角度看弥漫性轴索性脑损伤中的耳神经学症状]

[The otoneurological symptoms in diffuse axonal brain lesion from the age aspect].

作者信息

Blagoveshchenskaia N S, Meshcheriakova V V

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 1991 Sep-Oct(5):17-9.

PMID:1661987
Abstract

Since in the acute period of diffuse axonal craniocerebral trauma (CCT) the patient is comatose or, less frequently, soporous, only objective otoneurological signs (spontaneous nystagmus, altered caloric nystagmus, and traumatic damage to the otorhinolaryngological organs) may be revealed. The caloric nystagmus usually possesses all the signs characteristic of coma of different depth (absence of the caloric nystagmus in the absence of all reflexes, respiratory and cardiac disorders, total or partial loss of the rapid phase of the caloric nystagmus with the eye drifting and stopping in the direction of the slow phase of the nystagmus, the duration of such a reaction increases 3-4 fold on both sides, the vital functions are usually not disturbed in this syndrome). Both syndromes are manifested, as a rule, particularly distinctly in increasing brain edema. In the soporous state hyperreflexia of the caloric nystagmus from 2 sides was encountered with its sharp tonicity, occasional drifts of the eyes in the direction of the slow phase of the nystagmus at the peak of the caloric reaction, or hyperreflexia and tonicity of the caloric nystagmus in one direction was revealed in loss of the slow phase of the caloric nystagmus in the other direction. The last named was encountered in predominant edema of one of the cerebral hemispheres. Distinct correlations were noted as a rule between the features of the caloric nystagmus, the level of consciousness, and the degree of brain edema judged according to the findings of CT.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

由于在弥漫性轴索型颅脑创伤(CCT)急性期患者处于昏迷状态,或较少见的昏睡状态,因此仅可发现客观的耳神经学体征(自发性眼球震颤、冷热试验性眼球震颤改变以及耳鼻咽喉器官的创伤性损害)。冷热试验性眼球震颤通常具有不同深度昏迷的所有特征性体征(在所有反射、呼吸和心脏功能紊乱均缺失时冷热试验性眼球震颤消失,冷热试验性眼球震颤快相完全或部分丧失,眼球向眼球震颤慢相方向漂移并停止,双侧这种反应的持续时间增加3 - 4倍,该综合征中生命功能通常不受干扰)。通常,这两种综合征在脑水肿加重时表现得尤为明显。在昏睡状态下,可出现双侧冷热试验性眼球震颤的反射亢进及其明显的张力增高,在冷热反应高峰期偶尔出现眼球向眼球震颤慢相方向的漂移,或者在一侧冷热试验性眼球震颤慢相丧失时,另一侧出现单向的冷热试验性眼球震颤反射亢进和张力增高。后者见于一侧大脑半球的为主的水肿情况。通常根据CT检查结果判断,冷热试验性眼球震颤的特征、意识水平和脑水肿程度之间存在明显的相关性。(摘要截选至250字)

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