Wong G K, Tang B Y H, Yeung J H H, Collins G, Rainer T, Ng S C, Poon W S
Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Br J Neurosurg. 2009 Dec;23(6):601-5. doi: 10.3109/02688690902948184.
It is believed by many neurosurgeons that in addition to age and neurological status, the CT patterns of traumatic intracerebral haemorrhages are related to outcome. The aim of this study was to find out whether this is the case. The study was conducted in a regional level I trauma centre in Hong Kong. We prospectively collected data of patients with traumatic intracerebral haematomas over a 4-year period. Of 464 patients with head injuries, traumatic intracerebral haematoma was significantly associated with inpatient mortality and one year unfavorable outcome after adjustment for age, sex, post-resuscitation GCS, and presence of acute subdural haematoma. One hundred-and-fourteen patients had traumatic intracerebral haematomas and were included for further analysis. The mean age was 49, the male to female ratio was 2 to 1, and the median Glasgow Coma Scale (GCS) score on admission was 12. Logistic regression analysis showed that age and GCS score/GCS motor component score were significant factors for inpatient mortality, one-year mortality and one-year outcome. There was an association between temporal haematomas and inpatient mortality, subdural haematomas and inpatient mortality, and bilateral haematomas and unfavourable one-year outcome. In patients with severe head injury, a traumatic haematoma of more than 50 ml was associated higher inpatient mortality. In addition to age and GCS score, the CT patterns of bilateral haematomas, temporal haematomas and associated subdural haematomas were suggestive of poor outcome or mortality.
许多神经外科医生认为，除了年龄和神经状态外，创伤性脑内出血的CT表现与预后有关。本研究的目的是查明情况是否如此。该研究在香港一家地区一级创伤中心进行。我们前瞻性地收集了4年期间创伤性脑内血肿患者的数据。在464例头部受伤患者中，经年龄、性别、复苏后格拉斯哥昏迷量表（GCS）评分和急性硬膜下血肿的存在情况调整后，创伤性脑内血肿与住院死亡率和1年不良预后显著相关。114例患者有创伤性脑内血肿并被纳入进一步分析。平均年龄为49岁，男女比例为2比1，入院时格拉斯哥昏迷量表（GCS）评分中位数为12分。逻辑回归分析表明，年龄和GCS评分/GCS运动成分评分是住院死亡率、1年死亡率和1年预后的重要因素。颞叶血肿与住院死亡率、硬膜下血肿与住院死亡率以及双侧血肿与1年不良预后之间存在关联。在重度颅脑损伤患者中，血肿超过50 ml与较高的住院死亡率相关。除年龄和GCS评分外，双侧血肿、颞叶血肿及相关硬膜下血肿的CT表现提示预后不良或死亡率高。
