Eppinger B, Schumacher M
Sektion Neuroradiologie, Abteilung Röntgendiagnostik, Universität Freiburg.
Aktuelle Traumatol. 1988 Dec;18(6):235-9.
Clinical examination of severe brain injuries often suggests involvement of the brain stem and pontine structures not only via functional but also via structural lesions. Computer tomographic evidence of infratentorial trauma, however appears comparably rarely. 32 of 436 brain injured patients examined by CT showed traumatic infratentorial lesions. We examined these patients with regard to the distribution of structural damage, place of primary impact of force, incidence of skull fractures and accompanying supratentorial injuries, initial clinical status and clinical outcome. All but 2 patients were primarily unconscious. The lethal outcome in 7 patients was presumably due to the traumatic involvement of supratentorial structures. Patients with mainly infratentorial lesions--even with large epidural haematoma--showed a good recovery and fair rehabilitative outcome if the operation was performed immediately.
对重型脑损伤的临床检查常常提示，不仅通过功能损伤，而且通过结构损伤，脑干和脑桥结构也受到了累及。然而，幕下创伤的计算机断层扫描证据却相对少见。在接受CT检查的436例脑损伤患者中，有32例显示有幕下创伤性损伤。我们对这些患者的结构损伤分布、原发着力部位、颅骨骨折发生率及伴随的幕上损伤、初始临床状态和临床转归进行了检查。除2例患者外，其余患者最初均无意识。7例患者的死亡可能是由于幕上结构受到创伤累及所致。主要为幕下损伤的患者——即使伴有巨大硬膜外血肿——如果立即进行手术，也会有良好的恢复和较好的康复效果。
