| Brain injury is common injury, which hurts the central nervous system with high death rate and disability rate. Along with the development of modernization, the incidence of brain injury will increase gradually. So people show more and more concern about how to prevent, diagnose and treat brain injury and reduce its mortality and mutilation. Research shows that traumatic brain injury is only partial injury at an early stage, but followed by secondary injury within hours to days. The degree of brain injury not only depends upon essential injury but also closely associates with secondary injury. The prevention and cure of secondary damage is the important course in the clinical treatment of brain injury. The change of CBF is one of the important pathological and physiological changes of traumatic brain injury and at the same time there is stronger reaction of free radical after injury, which play an important part in secondary injury. The change of CBF and the reaction of free radical directly influence the case and prognosis of brain injury. From November 2006 to April 2007, our department performed SPECT and examined free radical on 60 emergency cases with brain injury to research the change of rCBF and the reaction of free radical after traumatic brain injury of various degrees, Then dynamically observe the change of rCBF and explore the relationship between the change of rCBF, the reaction of free radical and the clinical case, prognosis. The results are as follows:1. In 20 normal cases as control, SPECT cerebral blood perfusion imaging shows that cerebrum was clearly structured, radioactivity nuclide distributed equally, cerebral cortex was complete, limited sparseness and concentrated part were not found. SPECT -rCBF imaging and X-rayCT were performed in 60 patients with acute brain injury, and the results of two detection methods were compared. Results among 60 patients, SPECT examination found 53 cases (88.3%) of brain lesions, while X-rayCT only found 28 cases (46.6%). The positive diagnostic rate of SPECT was higher than that of CT, especially in mild brain injury.From the lesions detected, in 60 patients there were 26 positive cases by two detection methods, but in 26 cases, the number of lesions detected by SPECT (109) was significantly higher than that detected by X-rayCT (52). The lesion Sphere detected by SPECT was larger than that by X-rayCT. In 45 patients with mild brain injury, there were 11 positive cases detected by SPECT and X-rayCT. There were 27 positive cases detected only by SPECT, in which there were 14 cases with radioactivity nuclide decreasing or lesion at other parts of brain, while they were normal detected by X-rayCT. There were 2 positive cases only by X-rayCT, 5 negative cases by both SPECT and X-rayCT.With the recovery or improvement of rCBF and the decreasing of ischemia lesion, the case recovery or clinical symptoms were improved correspondingly. After one week of injury, SPECT perfusion imaging showed that there were 46 cases with lesion, 8 normal cases, 8 improved cases, 10 slightly improved cases, 3 ischemia worsening cases, in which 2 patients died after injury of 10 days and 11days. 25 cases without obvious change of CBF. There were 25 abnormal cases detected by X-rayCT. The case with low density and brain edema by X-rayCT, which was detected by SPECT rCBF imaging showed that there were decreasing radioactivity nuclide or incomplete regions, more over, the range of radioactivity nuclide decreasing or lesion was apparently larger than low density region. After two weeks of injury, detected by SPECT, there were 36 abnormal cases, 10 cases with normal CBF, 11 cases with improved CBF, 22 cases with slightly improvement, 3 cases without obvious changes. Detected by X-rayCT, there were 17 abnormal cases. After two weeks, X-rayCT showed that most of hemorrhage and edema faded, while SPECT showed that most patients were still with decreasing brain perfusion. 2. SOD: on the first day of injury, SOD activity in brain injury patients is significantly lower than in normal control. The more serious the brain injury, the lower SOD activity was. After that, it increased gradually. After two weeks, the indexes still didn't recover to normal level. The SOD activity remained decreasing in two deteriorated cases, who ended up in death.A conclusion can be drawn: The severity of brain injury correlated positively with rCBF decrease; the Changes of rCBF well reflected the degree of brain injury. The degree of secondary brain damage correlated with rCBF decrease, to be detected by SPECT is an important guideline; and SPECT examination shows that after brain injury, the change of rCBF correlated closely with the activity of free radical, which is an important guideline to judge prognosis; the degree of brain injury correlated with the activity of free radical. The degree of free radical activity is of significance in determining the state of illness and evaluating prognosis.
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