脑弥漫性轴索损伤的CT诊断

脑弥漫性轴索损伤（ＤＡＩ）是头部加速引起的脑白质轴索广泛性损伤。我们报告１８例脑弥漫性轴索损伤，提出ＤＡＩ的ＣＴ诊断标准：大脑皮髓质交界处、基底节内囊区域、胼胝体、脑干或小脑一个或多个直径≤２ｃｍ的出血灶，和／或脑室内出血，无明显颅内血肿和挫裂伤；或ＣＴ仅提示急性弥漫性脑肿胀、蛛网膜下腔出血，但伤后原发性持久昏迷，无脑缺氧情况。在３８６例急性脑外伤中，ＣＴ诊断ＤＡＩ１８例，对ＤＡＩ的发病机理、ＣＴ

The Diagnosis of Diffuse Axonal Injury

Diffuse axonal injury (DAI),i. e, widespread damage to axons in the white matter of the brain, is a well-recognized consequence of acceleration of the head. 18 cases was reported in this paper. We suggested the CT criteria for the diagnosis of DAI, that is, the presense of one or more hemorrhagic lesions less than 2 cm in diameter at the corticomedullary junction. Basal ganglia,internal capsule, corpus callosum, brain stem or cerebellum and/or intravertricular hemorrhage without obvious intracranial hematoma and contusion ; or only acute generalized brain swelling and subarachnoid hemorrhage on CT, but the patients had prolonged primary coma in the absence of brain hypoxia. DAI was diagnosed by CT in 18 out of 386 patients with acute brain injury. The pathogenesis, pathological basis of CT manifestations, diagnostic criteria, and the relationship between CT signs and clinical findings were discussed.