상이한 외상성 두개강내 병변이 동반된 외상성 뇌실질내 혈종의 임상적 비교 분석
Clinical Analysis of Traumatic Intracerebral Hematoma Associated with Other Traumatic Intracranial Lesions
소속 상세정보
최진호/Jin Ho Choi
송시헌/고현송/염진영/김성호/김윤/Shi Hun Song/Hyeon Song Koh/Jin Young Youm/Seong Ho Kim/Youn Kim
KMID : 0359819980270070917
Abstract
결론
외상성 뇌실질내 혈종에서 다른 외상성 두개강내 병변이 동반된 경우 단순 외상성 뇌실질
내 혈종보다 초기 신경학적 손상이 심하였고, 보다 나쁜 예후를 보였다. 또한 외상성 뇌실질
내 혈종환자의 내원시 일반적인 임상적 지표들이 양호하여도, 다른 외상성 두개강내 병변이
동반된 경우에는 나쁜 예후인자로 영향을 미치므로 이에 대한 적극적인 치료와 주의가 필요
할 것으로 생각된다.
#초록#
One hundreds eighty cases of traumatic intracerebral hematoma(TICH) among 1,633
head injury patients diagnosed with computerized tomography in neurosurgical
department from Jan. 1990 to Jun. 1996. were classified into two TICH groups ; TICH
group associated with other traumatic intracranial lesions and TICH group without other
traumatic intracranial lesions.
The incidence of TICH was 11.0% and percentage of TICH with other traumatic
intracranial lesions among 180 cases of TICH was 66.7%. TICH group with other
traumatic intracranial lesions showed worse initial level of consciousness, more likely to
have abnormal pupillary reflex, higher incidence of delayed traumatic intracerebral
hematomas(DTICH), greater amount of hematoma, increased chance of surgery and
worse outcome. In TICH group with other traumatic intracranial lesions, the factors
affecting prognosis were initial Glasgow coma scale(GCS) score, pupillary reflex, amount
of hematoma and treatment modality. In TICH only group, the factors affecting
prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH. The
patients with 12-15 of GCS score, normal pupillary reflex, absence of DTICH, and
amount of hematoma below 10cc, the presence of other traumatic intracranial lesions
were found to be important prognostic factor. The overall mortality was 27.7% but in
TICH group with other traumatic intracranial lesions, the mortality was 35.0% compared
to 13.3% in TICH only group. It is concluded from this study that in the case with
other traumatic intracranial lesions. TICH showed worse initial neurological status and
prognosis compared to those without other lesions. Thus, these patients, although in
conditions of good general clinical index at admission, should be considered to provide
intensive care and treatment because these associated lesions will play as a bad
prognostic factor.
키워드
Traumatic intracerebral hematoma; Traumatic intracranial lesions; Prognostic factor;
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