ABSTRACT
ObjectiveTo discuss the clinical characteristics and therapeutic strategy of acute epidural hematoma(EDH) with mixed density on CT.MethodsThe clinical data of 45 patients with acute EDH with mixed density on the first CT after trauma were analyzed retrospectively.Acute EDH form trauma with mixed density on CT images were compared with those which had homogenesis density on CT images at the same time.ResultsThe opportunity of increasing size of hematoma and the mortality was significantly higher in mixed density hematoma( 82.1％,16.2％ )than that of homogenesis density( 17.7％,2.3％ ) ( all P ＜ 0.01 ).ConclusionEDH with mixed density was a hyperacute EDH.The operation for acute EDH from trauma with mixed density on CT image should be prompt.
ABSTRACT
ObjectiveTo compare the effect of the neurosurgical clipping and endovascular for treating intracranial aneurysm.MethodsRetrospectively analyzed the clinical data of 110 cases with intracranial aneurysms.The patients were divided into intervention group(55 patients with endovascular treatment) and surgery group(55 patients with neurosurgical clipping treatment) according to different methods,followed forup 1 ～4 months,and immediately evaluated the efficacy.The Chinese stroke scale(CSS) and activities of daily living(ADL) score were used for prognostic evaluation.ResultsThe immediate effect:the marked efficacy in 40 cases,efficacy in 10 cases and inefficacy in 5 cases,and the total effective rate in the intervention group was 90.9％,while the surgery group were 32 cases,10 cases,13 cases,and the total effective rate was 76.4％.There was significantl differences between the two groups ( x2 =3.96,P ＜ 0.05 ) ; the CSS and ADL scores significantly lower than pre-treatment ( t =9.12,8.05,P ＜0.05).ConclusionEndovascular treatment for intracranial aneurysms could improve the clinical efficacy and improve patients self-care ability,and significantly improve the prognosis.
ABSTRACT
Objective To investigate the clinical characteristics and therapeutic strategy of acute subdural hematoma. Methods A restrospective study was carried out with a total of 94 consecutive ASDH patients who were confirmed through computed tomographic scan and obtained the clinical characteristics by experienced neurosurgeons.15 cases werepure acute subdural hematoma and the other 79 cases were acute compound subdural hematoma according to CT scan. Results In accordance with the GOS,36 cases had good recovery,19 cases had moderate disability,17 cases had severe disability and 22 cases dead. Conclusion The most important treatment for pure acute subdural hematom was to diagnose the source of bleeding, and acute compound subdural hematoma had poor prognosis than pure acute subdural hematoma since the traumatic severity. Early decraniuim by large bone flap to treat acute compound subdural hematoma could improve survival rate,reduce the fatality rate and decrease postoperative complications.
ABSTRACT
Objective To discuss the clinical characteristics and therapeutic strategy of contrecoup contusion and laceration in frontal lobe. Methods 48 cases with contrecoup contusion and laceration in frontal lobe were analysed retrospectively with their imaging feature. Results In accordance with the GOS,36 cases survived well, 8 suffered from moderate disability. One keept in persistent vegetative state and one was dead. Conclusion Contrecoup contusion and laceration in frontal lobe merged with occipital extradural hematoma and diffuse brain swelling. Early diagnosis and treatment for the delayed occipital extradural hematoma, and standard large trauma craniotomy in treatment of heavy contrecoup contusion and laceration with diffuse brain swelling in frontal lobe were the key measures to improve the rate of success rescue.
ABSTRACT
Objective We investigate lipid peroxidation of compressed myeloid tissue at early stage after decompression of chronic compressive spinal cord injury.Method SOD and MDA of compressed myeloid tissue are measured respectively before compression,before decompression and 3h after decompression.Result Increased MDA while decreased SOD of compressed myeloid tissue at 3h after decompression than before decompression.Conclusion The increased lipid peroxidation of compressed myeloid tissue at early stage after decompression of chronic compressive spinal cord injury.It is possible that it was resulted from ischemical reperfusion injury.
ABSTRACT
Objective To observe the effect of early mild hypothermia on the opening of tight junction of cerebral endothelial cells following traumatic brain injury in order to illustrate possible mechanism of low permeability of blood brain barrier (BBB) treated by mild hypothermia. Methods A total of 90 Wistar rats were randomly divided into normothermia control group (n=10),normothermia injury group (n=40) and mild hypothermia group (n=40). The opening state and its extent of tight junction were observed using lanthanum trace labeling with electron microscope. At the same time,water content of cerebral tissue at different phases in normothermia injury group and mild hypothermia group was measured by means of dry-wet weight and analyzed statistically. Results The tight junction was under preliminary opening three hours after trauma and reached the maximum opening within 24-48 hours after trauma,lasting for 72 hours in the normothermia injury group. However,slight opening appeared only in the mild hypothermia group. Water content of cerebral tissue in the mild hypothermia group lessened obviously in contrast to that in the normothermia injury group,with significant difference 3,24 and 72 hours after trauma ( P