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Eighteen cases of traumatic intraventricular hemorrhage (TIVH) were foundamong 270 cases of acute severe head injuries.Both clinical and computed-tomogra-phical studies of all these cases were analysed,The rate of TIVH was higher thanin other reports published before CT had come out,and the clinical condition ofthese patients was usually severe because they were usually associated with otherinjuries.Ventricular deformation and shearing force resulting from violence alongthe direction of the sagittal sinus... Eighteen cases of traumatic intraventricular hemorrhage (TIVH) were foundamong 270 cases of acute severe head injuries.Both clinical and computed-tomogra-phical studies of all these cases were analysed,The rate of TIVH was higher thanin other reports published before CT had come out,and the clinical condition ofthese patients was usually severe because they were usually associated with otherinjuries.Ventricular deformation and shearing force resulting from violence alongthe direction of the sagittal sinus were the main cause of hemorrhage.CT was themost important examination method and could be used to estimate the outcome ofthe patient which was related to GCS,the site of hemorrhage in the ventricles andthe therapy.The outcome in this series was better than in other reports,becauseventricular drainage and irrigation was given with balance of pressure as soon aspossible in addition to treatment for other brain injuries. 本文报告18例外伤性脑室内出血,该症临床并非少见,伤后病情均较严重。沿矢状寞方向作用的暴力引起脑室突然变形和剪力伤是造成脑室内出血的原因,CT 是主要检查手段,不但准确而且能估价预后。本病疗效与脑室出血部位和意识障碍程度有关,同时与是否及时行脑室外引流、脑室冲洗有关。本组疗效较文献报告为佳。 Thirty two cases of traumatic intraventricular hemorrhage (TIVH) confirmed by CT were reviewed. These patients should be treated with various methods because they usually suffered from other types of severe head injuries and the patients’ condition was complicated. We suggest: 1. TIVH associated with severe contusion and laceration of the brain or large intracranial hematoma demonstrated by CT should be given craniectomy to clear hematoma, cerebral decompression and ventricular drainage as soon as possible.... Thirty two cases of traumatic intraventricular hemorrhage (TIVH) confirmed by CT were reviewed. These patients should be treated with various methods because they usually suffered from other types of severe head injuries and the patients’ condition was complicated. We suggest: 1. TIVH associated with severe contusion and laceration of the brain or large intracranial hematoma demonstrated by CT should be given craniectomy to clear hematoma, cerebral decompression and ventricular drainage as soon as possible. 2. The patients whose CT doesn’t show the distinct occupying in the injured area and GCS beyond eight could be given conservative treatment temporarily. 3.If GCS is below eight, the patients should be given ventricular drainage in time and the ventricle irrigation with nomal saline solution repeatedly. 4. The TIVH associated with emergent high pressure hydrocephalus should be given ventricular drainage, whereas for the delayed high pressure hydrocephalus, the patients should be given ventriculo peritoneal shunt. 报道经CT证实的外伤性脑室内出血(TIVH)32例患者。TIVH往往合并其他类型严重颅脑损伤,病情复杂,在治疗上应采取不同的方法:①对于CT发现合并有明显占位效应的颅内血肿或严重脑挫裂伤者,应早期手术清除血肿及减压,同时行脑室外引流术。②CT表现占位效应不明显,GCS在8分以上者,可暂行保守治疗。③CT表现占位效应不明显,GCS在8分以下者,应及时行脑室外引流术,同时用生理盐水等压反复冲洗脑室。④对早期高压性脑积水应行脑室外引流术,晚期则行侧脑室—腹腔分流术。TIVH预后主要与病人年龄、入院时GCS、脑室内积血是否及时排出有关。笔者还对TIVH的发病机制、临床特点进行探讨。 Objective: To analysis the pathogenesis , clinic features, CT manifestions, complications and prognosis of traumatic intraventricular hemorrhage (TIVH).Materials and Methods:36 cases of TIVH were retrospectively analysed.Results:Theywere primary TIVH 24 cases, secondary TIVH 12 cases, hemorrhage of unilateral ventricle 10 cases, bilateral ventricles 7 cases, bilateral ventricles and third ventricle 4 cases, within the limits of fourth ventricle 2 cases, hemorrhage involved all ventricles 13... Objective: To analysis the pathogenesis , clinic features, CT manifestions, complications and prognosis of traumatic intraventricular hemorrhage (TIVH).Materials and Methods:36 cases of TIVH were retrospectively analysed.Results:Theywere primary TIVH 24 cases, secondary TIVH 12 cases, hemorrhage of unilateral ventricle 10 cases, bilateral ventricles 7 cases, bilateral ventricles and third ventricle 4 cases, within the limits of fourth ventricle 2 cases, hemorrhage involved all ventricles 13 cases. 29 cases have intracranial complications.Conclusion: CT should be the examination of first choice and should be used in this disease. 目的:分析外伤性脑室内出血的发生机理、临床特点、CT表现、并发症及预后。材料与方法:回顾性分析外伤性脑室内出血患者36例。结果:原发性外伤性脑室内出血24例,继发性外伤性脑室内出血12例;单侧侧脑室出血10例,双侧侧脑室出血7例,双侧侧脑室及三脑室出血4例,单纯四脑室出血2例,全脑室出血13例。29例有颅内合并症。结论:CT检查是诊断该病的首选和必查项目。
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