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本文报道3例经 CT 检查确定脑干损伤出血但其余脑部无明显或严重损伤。临床捡查发现有上段脑干损伤的症征但无持续昏迷和去脑强直且预后良好,基于此3例病人的发现,作者认为:原发性脑干损伤是存在的,且可不伴随弥漫性脑损伤而存在。原发性脑干损伤的问题并非是损伤的存在与否而是传统的临床概念存在问题。原发性脑干损伤可以在没有持续昏迷与去脑强直即所谓典型症征的条件下存在,但诊断必须得到 CT 扫描的支持。
Abstract：Three patients with primary brain stem injury were diagnosed by CT scanning and clinical analysis.The scanning shows brain stem hemorrhage but no obvious changes in the other parts of the brain.Physical examina- tion showed signs of upper brain stem lesion without persistent coma and decerebrate rigidity.On these findings,the author believes that primary brain stem injury does exist,but may not necessarily accompany diffuse brain injury.The primary brain stem injury may appear without so-called characteristic feature but the diagnosis must be supported by CT scanning.
1． Crompton M R.Brainstem lesions due to closed head injury.Lancet 1971;1:669-673．
2． Bakay L,Glasauer F E.Head Injury.Boston:Little Brown and Co,1980;110-111．
3． Mitchell D E,Adams J H.Primary focal impact damage tothe brain stem in blunt head injuries.Does it exist?Lancet 1973;2:215-218．
4． Bruce D A.Clinical reflections on brain stem injury in childhood.In Villani R(edited).Advances in neurotraumatology.Amsterdam-Oxford-Princeton:Excerpta Medica,1984:74．
5． Ommaya A K.Mechanisms of cerebral concussion,contusions and other effects of head injury.in Youman J R(edited).Neurological Surgery.vol 4． ed 2． Philadelphia:W B Saunders Co,1982;1879-1887．
6． Plum F,et al.The diagnosis of stupor and coma.Philadelphia:F A Davis Co,1980,13-14．
7． Halsey J H,et al.Decerebrate rigidity with presservation of consciousness.J Neurol Neurosurg Psychiat 1966;29:350-355．
8． Bricolo A,et al.Decerebrate rigidity in acute head injury.J Neurosurg 1977;47:680．
9． Becker D P,et al.Diagnosis and treatment of head injury in adults.in Youman J R(edited).Neurological Surgery.vol 4． ed 2． Philadelphia:W B Saunders Co.1982:1942．
10． Shakir R A(孙振声摘译).无持续意识丧失的外伤性脑干血肿.国外医学神经病学神经外科学分册1985;12(3) :166．
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引用信息:
[1]李镜荣.原发性脑干损伤的临床诊断问题[J].广州医学院学报,1987(02):44-48.
1987-07-02
1987-07-02