妊娠晚期并发重型颅脑损伤虽属少见,但这类患者如处理不当,常造成母、婴死亡。脑外科和妇产科医师密切配合,拟定妥善的治疗方案,才能降低死亡率。现将我院1974年以来遇到妊娠晚期并发重型颅脑损伤2例报道如下。例1、26岁,工人。1974年2月10日因从楼梯上滑下跌伤2小时入院,当时昏迷伴频繁呕吐,继而深昏迷,深浅反射消失,左侧瞳孔略大于右侧,颅骨拍片:左侧额颞骨线形骨折。开颅探查:左侧颞部硬脑膜外、下多发性血肿,去颅骨瓣减压,术后第7天拆线,伤口一期愈合,术后20天清醒。患者停经9个月,宫底于剑突下2横指,妇产科检查有胎儿头盆不称。在局麻下剖宫产一男活婴,重3.2kg,术后经过顺利,血压稳定,神志清楚,共住院50天,母子均健康出院。例2、21岁,农民。于1981年6月16日被自行车撞倒,头枕部着地当即昏迷,有中间好转期,15小时转来我院,停经7月~+。检查:T38.9℃,P102次/分R25次/分,Bp100/50mmHg。鼾声呼吸有痰鸣,呈深昏迷状态,瞳孔右>左,光反射消失,GCS:4分。腹部膨起,可见妊娠纹、乳晕色素沉着。子宫底于脐上3横指。入院诊断:重型颅脑损伤。妊娠7月~+。入院后立即在气管插管加局麻下行开颅探查术,术后诊断:左额部硬脑膜下血肿,右额颞部脑挫裂伤。清除血肿并去大颅骨瓣减压,气管切开,术后7 Severe craniocerebral injury during pregnancy is rare, but such patients, such as improper handling, often resulting in mother and infant deaths. Brain surgery and obstetrics and gynecology physicians work closely to develop a proper treatment program, in order to reduce mortality. I now meet in our hospital since 1974, complicated by severe traumatic brain injury in 2 cases reported below. Example 1,26 years old, worker. February 10, 1974 because of falling from the stairs fell 2 hours injury admission, when coma with frequent vomiting, then deep coma, the depth of reflex disappeared, the left pupil slightly larger than the right, skull film: Frontal temporal bone line fractures. Exploratory craniotomy: the left temporal dura, multiple hematoma under the skull flap decompression, stitches the first 7 days after surgery, wound healing, sober after 20 days. Patients with menopause 9 months, 2 at the end of the fundus in the xiphoid mean obstetric and gynecological examination of fetal head basin is not known. Cesarean section under local anesthesia a male live baby, weighing 3.2kg, after a smooth, stable blood pressure, conscious, a total of 50 days hospitalized, both mother and child were discharged. Example 2,21 years old, farmer. On June 16, 1981 was knocked down by a bicycle, the first occipital area immediately unconscious, the middle of a good transition, 15 hours transferred to our hospital, menopause July ~ +. Check: T38.9 ℃, P102 times / min R25 times / min, Bp100 / 50mmHg. Snore breathing sputum Ming, was a deep coma, pupil right> left, light reflex disappeared, GCS: 4 points. Abdomen bulge, visible stretch marks, areola pigmentation. Uterus at the end of the umbilical 3 horizontal means. Admission diagnosis: severe head injury. Pregnancy July ~ +. Immediately after admission in the endotracheal intubation local anesthesia craniotomy, postoperative diagnosis: left forehead, subdural hematoma, right frontotemporal contusion. Remove the hematoma and go to a large skull flap decompression, tracheotomy, postoperative 7