Schneider R, Mauer U M, Waldbaur H, Oldenkott P
Neurochirurgische Abteilung, Bundeswehrkrankenhauses Ulm, Universität Ulm.
Unfallchirurg. 1993 Nov;96(11):587-90.
Traumatic intracerebral haematomas are a common neurosurgical emergency. The role of surgical removal is controversial. The diagnosis and treatment of life-threatening thoracic or abdominal haemorrhage is more urgent than are measures undertaken by the neurosurgeon. In the present paper we report on 318 patients with severe head injury. In 161 cases (38 female, 123 male) CT investigation showed a a resulting from contusion. About a third of each group of patients, both with and without contusion-induced haematomas, were 21-30 years old. The mortality rate was 18.6%. Multiple contusion haematomas occurred in 36%, and solitary ones in 64%. The diagnostic investigations showed contusion haematomas in isolation only in 10.6% of patients. All others had additional injuries: epidural haematomas in 24 cases, subdural haematomas in 29, depressed fractures of the skull in 6, and traumatic subarachnoid haemorrhage in 37. Only 10 patients underwent operative removal of their contusion haematomas by trepanation and 2 others by stereotactic puncture.
创伤性脑内血肿是一种常见的神经外科急症。手术清除的作用存在争议。危及生命的胸腹部出血的诊断和治疗比神经外科医生采取的措施更为紧迫。在本文中，我们报告了318例重度颅脑损伤患者。在161例（38例女性，123例男性）中，CT检查显示有因挫伤导致的血肿。每组患者中，无论有无挫伤性血肿，约三分之一的患者年龄在21至30岁之间。死亡率为18.6%。多发性挫伤性血肿占36%，单发性血肿占64%。诊断性检查显示仅10.6%的患者存在孤立性挫伤性血肿。所有其他患者都有其他损伤：硬膜外血肿24例，硬膜下血肿29例，颅骨凹陷性骨折6例，创伤性蛛网膜下腔出血37例。只有10例患者通过开颅手术清除挫伤性血肿，另外2例通过立体定向穿刺清除。
