Levinthal R, Stern W E
Surg Neurol. 1977 May;7(5):269-73.
The possibility of an intracerebral hematoma may be overlooked in the presence of a "fixed" neurologic deficit. The clinical complex that is emphasized is composed of (a) ipsilateral cranial trauma, (b) early development of focal neurological deficit, (c) a plateau in the subsequent course of the disease, (d) the delayed appearance of a positive radioactive isotope scan, and (e) a focal area of distorted vessels in angiographic studies. The availability of the computer tomographic scan has made the diagnosis of intracerebral hematomas more certain but it is important that the possibility of a hematoma be considered and pertinent investigations be performed. Even after diagnosis, an operative procedure may be delayed in patients who are neurologically stable. In the five cases presented, the diagnosis of cerebral contusion led to a delay in operative evacuation which was associated with improvement in the previously stable neurological deficit.
在存在“固定性”神经功能缺损的情况下，脑内血肿的可能性可能会被忽视。所强调的临床综合表现包括：(a) 同侧颅脑外伤；(b) 局灶性神经功能缺损的早期出现；(c) 疾病后续病程中的平稳期；(d) 放射性同位素扫描阳性的延迟出现；(e) 血管造影研究中血管扭曲的局灶性区域。计算机断层扫描的应用使脑内血肿的诊断更加确定，但重要的是要考虑到血肿的可能性并进行相关检查。即使在诊断之后，对于神经功能稳定的患者，手术操作也可能会延迟。在所呈现的5例病例中，脑挫伤的诊断导致手术清除延迟，这与之前稳定的神经功能缺损的改善相关。
