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目的探讨创伤性大脑浅静脉损伤机制与创伤性脑梗死的关系对预后的影响及对创伤性大脑浅静脉的有效处理措施。方法2006-06~2007-02我科收治颅脑损伤患者330例,其中18例合并有术中证实的大脑浅静脉损伤。分析本组患者的临床及影像学资料。结果伴有大脑浅静脉损伤的18例中合并颅骨骨折12例,18例均合并有急性硬膜下或脑内血肿,并发有不同程度的创伤性脑梗死。伤后6个月,18例患者中预后较佳5例,预后不佳13例。结论颅骨骨折直接损伤是导致大脑浅静脉损伤的主要原因,大脑浅静脉损伤是导致创伤性脑梗死的重要原因,合并有大脑浅静脉损伤的颅脑损伤患者预后差,死残率高。术中注意保护受损大脑浅静脉和给予受损静脉周围充分减压,以及术后防止受伤静脉栓塞和血管痉挛是提高此类患者预后的有效措施。
Objective To explore the relationship between traumatic cerebral superficial venous injury mechanism and traumatic cerebral infarction and its effect on prognosis and effective treatment of traumatic cerebral superficial vein. Methods From 2006-06 to 2007-02, 330 cases of craniocerebral injury were treated in our department. Among them, 18 cases were complicated with intraoperatively confirmed superficial cerebral venous injuries. Analysis of the clinical and imaging data of this group of patients. Results In the 18 cases with superficial cerebral venous injury, 12 cases were complicated with skull fractures. All 18 cases had acute subdural or intracerebral hematoma complicated with traumatic cerebral infarction. Six months after injury, the prognosis of the 18 patients was better in 5 cases and the prognosis was poor in 13 cases. Conclusion The direct injury of skull fracture is the main cause of superficial cerebral venous injury. Superficial cerebral venous injury is an important cause of traumatic cerebral infarction. The patients with craniocerebral injury complicated by superficial cerebral venous injury have poor prognosis and high mortality rate. Intraoperative attention to protect the superficial cerebral venous damage and give adequate decompression around the damaged veins, as well as to prevent injury after venous thrombosis and vasospasm is an effective measure to improve the prognosis of such patients.