Reilly P L, Graham D I, Adams J H, Jennett B
Lancet. 1975 Aug 30;2(7931):375-7. doi: 10.1016/s0140-6736(75)92893-7.
Of 66 patients with head injuries who had talked at some time after injury, 25% did not have intracranial haematoma at necropsy. Most of these had raised intracranial pressure (I.C.P.), and the commonest finding was local swelling related to contusions. Almost half of the non-haematoma cases had ischaemic or hypoxic brain damage, usually without contusions; 3 were children who had had status epilepticus. Fatality without raised I.C.P. was most often due to meningitis. In deteriorating patients without haematoma mortality and morbidity might be reduced by more diagnosis and treatment, particularly of raised I.C.P.
在66例受伤后曾在某个时间点有过交谈的头部受伤患者中,25%在尸检时没有颅内血肿。其中大多数患者颅内压升高,最常见的发现是与挫伤相关的局部肿胀。几乎一半的非血肿病例有缺血性或缺氧性脑损伤,通常没有挫伤;3例是患有癫痫持续状态的儿童。颅内压未升高的死亡最常见原因是脑膜炎。在病情恶化的无血肿患者中,通过更多的诊断和治疗,特别是对颅内压升高的诊断和治疗,死亡率和发病率可能会降低。