遲發外傷性腦內血腫

Delayed Traumatic Intracerebral Hematoma

謝慶良(Ching-Lang Shieh) ； 李仁杰(Reng-Jye Lee) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 10卷1期 (1985/03) Pp. 75-80

摘要

遲發外傷性腦內血腫(delayed traumatic intracerebral hematoma-DTIH)，在未有電腦斷層攝影(computerized tomography-CT)檢查以前，一般認為並不常見，但自使用CT以來，確認其發生率遠較以前想像者為高，約在7.4-8.5%之間。多數學者認為遲發外傷性腦內血腫是臨床上很難克服的問題，死亡率(mortality)大約為50%，而一般頭部外傷死亡率約為33%。所以早期診斷，適時治療以降低死亡率並減少殘廢的程度，除了密切的臨床觀察及神經功能的評估外，電腦斷層攝影檢查確係早期察覺遲發性外傷性腦內血腫的最好方法。本文報告三個遲發外傷性腦內血腫的病例，三例分別發生於16小時，三天及五天內。一例接受外科手術治療結果良好，未接受外科手術治療之兩例一例死亡，一例恢復良好。中華放射醫誌10:75-80，1985。

並列摘要

Delayed traumatic intracerebral hematomas (DTIH) are generally considered to be uncommon until recently, the serial CT scanning has shown that the incidence of delayed traumatic intracerebral hematoma is much higher than was previously believed and is about 7.4-8.5%. The contribution of CT scanning to the early diagnosis of DTIH permitting prompt appropriate surgical or supportive management and decreasing the mortality rate is emphasized. Three cases of DTIH are presented and the interval from head injury to diagnosis of DTIH by scanning is 16 hours, 3 days and 5 days respectively. One patient did well after surgical treatment, the other two with conservative management, one died and one recovered well. Chinese J. Radiol. 10: 75-80, 1985.