Vogel T, Ockert B, Krötz M, Linsenmaier U, Kirchhoff C, Pfeifer K J, Mutschler W, Mussack T
Klinik für Orthopädie und Unfallchirurgie, Klinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791 Bochum, Deutschland.
Unfallchirurg. 2008 Nov;111(11):898-904. doi: 10.1007/s00113-008-1502-0.
The aim of the study was to quantify the occurrence of progressive intracranial bleeding (PIB) and to identify concomitant parameters in patients suffering from traumatic brain injury (TBI).
TBI patients were included if initial and serial cranial computed tomography (CCT) scans were conducted within 24 h after trauma. A progression of > or =25% was considered as PIB. Patients with progression were compared to those with constant bleeding regarding clinical parameters, time lapse and coagulation status.
A total of 98 patients with TBI and intracranial hemorrhaging were analyzed. PIB was detected in 45 patients showing significantly more intracerebral bleeding as well as fractures to the skull (p<0.05), compared to patients with constant bleeding. No significant differences between the groups regarding demographic and clinical parameters, time interval between trauma and initial CCT, and coagulation status were found.
Early progression of intracranial hemorrhaging occurs in nearly every second TBI patient and is recognized frequently in cerebral contusions and after fractures to the skull. Hence, early repeated CT scanning is indicated in all TBI patients suffering from intracranial bleeding.
本研究旨在量化进行性颅内出血（PIB）的发生率，并确定创伤性脑损伤（TBI）患者的相关参数。
如果在创伤后24小时内进行了首次及系列头颅计算机断层扫描（CCT），则纳入TBI患者。进展超过或等于25%被视为PIB。将进展患者与出血稳定患者在临床参数、时间间隔和凝血状态方面进行比较。
共分析了98例TBI合并颅内出血患者。45例患者检测到PIB，与出血稳定患者相比，这些患者脑内出血和颅骨骨折明显更多（p<0.05）。两组在人口统计学和临床参数、创伤与首次CCT之间的时间间隔以及凝血状态方面未发现显著差异。
几乎每例TBI患者都会出现颅内出血的早期进展，在脑挫裂伤和颅骨骨折后经常出现。因此，所有颅内出血的TBI患者均需早期重复进行CT扫描。
