An Analysis On Clinical Correlation Factors Of Adult Traumatic Cerebral Infarction

Objective: To discuss the clinical correlation factors which induced adult traumatic cerebral infarction.Methods: To select 42 patients of the First Hospital of Jinzhou district from June 2002 to June 2008, and to summarize their clinical manifestations, imaging characteristics and prognosis through retrospective analysis.Results: The patients whose GCS≤8 when they were on admission were 24 cases,accounting for 57.14%; GCS: 9-12 were 11 cases, accounting for 26.19%; GCS: 13-15 were 7 cases, accounting for 16.67%. GOS was scale standard when the patients discharged from hospital. There were 18 patients who were dead, vegetable and severe disability, two cases were due to brain stem infarction after brain stem injury among them, the others were a large area of post-traumatic cerebral infarction. The more serious cerebral trauma and lower GCS is, the more larger probability occurred traumatic cerebral infarction is, and the more number of large area cerebral infarction is. All of 42 cases occurred to intracranial hemorrhage in varying degrees, suggesting that vascular injured. All the cases appeared as intracranial hypertension, mannitol, furosemide and other dehydration drugs were used routinely early, some cases used hemostatic drugs in the first 3 days of admission, at the same time, they were fasting water, these caused hypovolemia, hypoperfusion, hypercoagulabale state,most of the patients occurred to cerebral infarction in 3 days after trauma; patients whose cerebral vessel were pressed because of brain hernia were 13 cases, accounting for 30.92%, subarachnoid hemorrhage were 21 cases, accounting for 50%. The prognosis of patients who had small infarct size were better through conservative treatment by drugs; some patients had large infarct size and significant occupying effect, their therapeutic efficacy is not satisfactory through the extracranial and/or intracranial decompression at the same time by drugs, and the prognosis were poor. However, the prognosis of a small number of cases were improved significantly through early detection of CT and early surgical treatment.Conclusion: 1, The more serious cerebral trauma is, the more larger probability occurred traumatic cerebral infarction is, and the prognosis is worse. 2, The main factor causing to traumatic cerebral infarction is cerebral vascular's mechanical injury, the secondary factor is hypoperfu- sion and hypercoagulability of blood. 3, The prognosis is poor when traumatic cerebral infarction occurred. If we diagnose it early through the brain CT perfusion imaging and MRI, perform timely decompression craniotomy, superselective intraarterial thrombolysis technique or extra- intracranial artery anastomosis, with the drug treatment such as fluid expansion, anticoagulation, prevention of vasospasm, and so on, we can improve the prognosis.