The Relationship Between Midline Shift And Bilateral Crural Cisterns,Ambient Cisterns Compression And Prognosis In Traumatic Acute Frontal-temporal-parietal Subdural Hematoma Patients

Objective To find the relationship between midline shift,bilateral crural cisterns,ambient cisterns compression and prognosis in traumatic acute frontal-temporal-parietal subdural hematomaMethod we conduct a retro-perspective research with 50 traumatic acute frontal-temporal-parietal subdural hematoma patients. Ecah case was measured the displacement of the septum pellucidum,the anterior segment of the interhemispheric fissure cistern and the third ventricle,and we also measured the compression degree of the bilateral crural cisterns and ambient cisterns. All patients were followed up for at least six months,and the six-month prognosis was collected. All data was tested with SPSS 17.0 software.Result 50 patients were collected and divided into five groups by six-month prognosis. There are 10 patients(20%) in the GOS-1 score group,2(4%) in the GOS-2 score group,8(16%) in the GOS-3 score group, 12(24%) in the GOS-4 score group,and 18(36%) in the GOS-5 score group. The displacement of the septum pellucidum,the anterior segment of the interhemispheric fissure cistern and the third ventricle were negatively correlated with the six-month prognosis(P<0.05),the spearman correlation coefficient were -0.454,-0.468 and -0.425 seperately. The compression degree of the ipsilateral and Contralateral crural cisterns,the ipsilateral and Contralateral ambient cisterns were negatively correlated with the six-month prognosis(P<0.05),the spearman correlation coefficient were -0.869, -0.689,-0.577,-0.605 seperately. The mortality rate was 52.6% when the ipsilateral crural cistern of hematoma disappeared,and the mortality rate became 70% when the bilateral crural cisterns disappeared,71.4% when the bilateral crural cisterns and Contralateral ambient cistern disappeared,85.7% when the bilateral crural cisterns and bilateral ambient cisterns disappeared.Conclusion The displacement of the septum pellucidum and the anterior segment of the interhemispheric fissure cistern have relatively stronger correlation with the prognosis,while the third ventricle has weaker correlation with it;the correlation of the four structures of the cisterns mentioned above with prognosis were displayed in descending order as follows: ipsilateral crural cisterns, Contralateral crural cisterns, Contralateral ambient cisterns, ipsilateral ambient cisterns. In severe traumatic acute frontal-temporal-parietal subdural hematoma patients,the compression of the bilateral crural cisterns and ambient cisterns may be more important than the midline shift in prognosis judgement.