On Diagnosis And Treatment Of Familiar Neurosurgical Diseases

Objective In clinical practice, diffuse axonal injury (DAI) and primary brain-stem injury (PBSI) are so confusable with each other that identification is often required. On the other hand, from the point view of injury mechanism, they are incurred from the same basis, which in turn need further distinguishing. By analyzing the similarity and difference of these two diseases, this paper may be regarded as a good reference for diagnosis and treatment. Methods Based on the clinical symptom and the character of CT/MRI, we analyzed retrospectively and followed up 54 DAI cases. Results Among all of the patients diagnosed as DAI according to the diagnostic standard, 7 cases were found to be non-abnormal under CT scan while having typical DAI character under MRI scan; 11 cases had SAH under CT scan and typical DAI character under MRI scan. For all of the 45 cases that were found to have typical DAI character under CT or MRI scan, 34 were on the borders of the brain cortex and the medulla, 14 were on the basal ganglia, 25 were on the callose, 13 were on the brain-stem, 6 were on the ventricle and 9 were on the cerebel. Conclusion DAI is a kind of familiar diffuse brain injury that includes the axonal injury of the brain stem. On contrary, PBSI is a kind of primary injury limited on the brain-stem, which includes the axonal injury of brain-stem and the contusion or hematoma of brain-stem and is a kind of localized brain injury that rarely happened. When the image data were insufficient or absent, they are very easy to be mixed up with each other and we have to pay more attention to the difference between them.