Miki T, Ikeda Y, Utsugi O, Ito H
Department of Neurosurgery, Tokyo Medical College, Japan.
J Clin Neurosci. 1998 Jan;5(1):49-57. doi: 10.1016/s0967-5868(98)90202-8.
Traumatic subarachnoid haemorrhage (TSAH) is a computed tomography (CT) scan finding frequently found in the acute phase of brain injury. However, the clinical evaluation of TSAH is controversial. The subjects in the present series consisted of 46 patients in whom the initial CT scan within 6 h after injury revealed a high density area in the subarachnoid space. The subjects were divided into three types: type 1 n = 10) had massive haemorrhage in the basal cisterns; type II (n = 9) had localized haemorrhage in the basal cisterns; and type III (n = 27) had localized haemorrhage in the cortical sulci or Sylvian fissure. The clinical and neuroradiological findings as well as the outcome of these three types of TSAH are discussed. The results of our study showed that TSAH observed at an acute stage of head trauma was associated with a great variety of intracranial pathological changes. Type I cases had either good or poor outcome, and diffuse brain injury was predominant in patients with poor outcome. The outcome was generally good in type II and III cases.
创伤性蛛网膜下腔出血(TSAH)是在脑损伤急性期经常发现的一种计算机断层扫描(CT)表现。然而,TSAH的临床评估存在争议。本系列研究的对象包括46例患者,他们在受伤后6小时内进行的首次CT扫描显示蛛网膜下腔有高密度区。这些对象被分为三种类型:1型(n = 10)在基底池有大量出血;II型(n = 9)在基底池有局限性出血;III型(n = 27)在皮质沟或外侧裂有局限性出血。本文讨论了这三种类型TSAH的临床和神经放射学表现以及预后情况。我们的研究结果表明,在头部创伤急性期观察到的TSAH与多种颅内病理变化有关。1型病例的预后有好有差,预后差的患者以弥漫性脑损伤为主。II型和III型病例的预后通常较好。