Uzzell B P, Dolinskas C A, Wiser R F
Division of Neurosurgery, University of Pennsylvania School of Medicine, Philadelphia 19104.
Adv Neurol. 1990;52:269-74.
Long-term neuropsychological recovery of 24 severe head-injured patients was examined and correlated with acute measurements of intracranial pressure (ICP) and diffuse computed tomographic (CT) lesions. Intracranial hypertension (ICP greater than or equal to 20 mm Hg) was present acutely in 12 patients and absent in 12 patients. CT diagnoses of diffuse swelling (DS) was present in 12 patients, and diffuse axonal injury (DAI) in 12 patients. During chronic recovery, neuropsychological dysfunctioning was found in all cases. Patients with acute ICP elevations showed more intellectual and memory losses than those without acute ICP elevations. No neuropsychological differences were found between patients with DS and DAI injuries. The findings suggest secondary brain insults caused by intracranial hypertension may be more disruptive to long-term neuropsychological functioning than diffuse lesion type.
对24例重度颅脑损伤患者的长期神经心理恢复情况进行了检查，并将其与颅内压（ICP）的急性测量值及弥散计算机断层扫描（CT）损伤情况进行关联分析。12例患者急性期存在颅内高压（ICP大于或等于20 mmHg），12例患者无颅内高压。12例患者CT诊断为弥漫性肿胀（DS），12例患者诊断为弥漫性轴索损伤（DAI）。在慢性恢复过程中，所有病例均发现神经心理功能障碍。急性期ICP升高的患者比未出现急性期ICP升高的患者表现出更多的智力和记忆丧失。DS和DAI损伤患者之间未发现神经心理差异。研究结果表明，颅内高压引起的继发性脑损伤可能比弥漫性损伤类型对长期神经心理功能的破坏更大。
