Hennes H, Losek J D, Sty J R, Gill J C
Department of Pediatrics, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee 53233.
Pediatr Emerg Care. 1987 Sep;3(3):147-9. doi: 10.1097/00006565-198709000-00002.
Intracranial hemorrhage secondary to head trauma is a major cause of morbidity and mortality in patients with bleeding disorders. Indications for head computerized tomographic scanning (CT scan) on patients with bleeding disorders who sustain head trauma are not well established. We retrospectively reviewed the medical records and head CT scan results of 21 patients with bleeding disorders. Five patients had more than one episode of head trauma. The severity of head trauma per episode was classified according to objective clinical findings as minor in 12 episodes, moderate in 12, and severe in four. In three of four patients with severe head trauma, the CT scan showed evidence of intracranial hemorrhage. In this series, all 17 patients with 24 episodes of moderate or minor head trauma had normal head CT scans. We conclude that a larger prospective study is needed to further evaluate the diagnostic value of head CT scan in hemophilia patients with minor or moderate head trauma, as defined in this study.
头部创伤继发的颅内出血是出血性疾病患者发病和死亡的主要原因。对于头部创伤的出血性疾病患者，进行头部计算机断层扫描（CT扫描）的指征尚未明确确立。我们回顾性地分析了21例出血性疾病患者的病历和头部CT扫描结果。5例患者有不止一次头部创伤发作。根据客观临床发现，每次头部创伤的严重程度分类如下：12次为轻度，12次为中度，4次为重度。在4例重度头部创伤患者中，有3例CT扫描显示有颅内出血迹象。在本系列中，所有17例有24次中度或轻度头部创伤发作的患者头部CT扫描均正常。我们得出结论，需要进行更大规模的前瞻性研究，以进一步评估如本研究所定义的轻度或中度头部创伤的血友病患者头部CT扫描的诊断价值。
