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asbryobvrz · Wysłany: Śro 7:23, 09 Mar 2011

Characteristics of traumatic intraventricular hemorrhage and treatment experience

Conservative treatment (Ⅲ, Ⅳ posterior horn of lateral ventricle or both sides of the part of all the blood in 5 patients treated conservatively.) 29 cases in which patients undergoing double-EVD intraventricular injection of urokinase. Each urokinase 10000u, once every 12 hours, keep an open drainage tube after 2-3 hours a day,[link widoczny dla zalogowanych], bloody drainage of cerebrospinal fluid 200 ~ 30Oral, retention of the unit: 317500 Wenling, Wenling City, Zhejiang Province People's Hospital EVD first time 5 to 12 days. An average of 7.6 days, review the CT and three confirmed in the cerebral aqueduct, fourth ventricle smooth, lateral remnants of blood in the folder came from a drainage tube can be tested, observed for 24 hours without symptoms of increased intracranial pressure can be removed when the drainage tube. Early stage non-surgical patients were lumbar puncture drainage, bloody CSF release, while routine inspection of cerebrospinal fluid to fluid color clear. 1.4 Results: The prognostic score at discharge standards based on COS ..., good in 36 cases, moderate disability in 6 cases, 4 cases of severe disability, persistent vegetative 0 cases, 15 cases died (24.6%). Among them, 13 cases were died of brain stem failure. 2 patients died of pulmonary infection. 2 intraventricular hemorrhage in the discussion of traumatic intraventricular hemorrhage can be divided into primary and secondary intraventricular hemorrhage in two, often associated with diffuse axonal injury, intracerebral hematoma, brain contusion, skull fracture and other traumatic brain injury, the condition often serious, reported mortality as high as 40% f2j. Cause of primary intraventricular hemorrhage is not clear. It was suggested that diffuse white matter caused by external forces of wall shear stress and the brain rupture, causing blood vessels beneath the ependymal rupture [31. CT in this group of 15 patients seen at the junction of cortex and medulla,[link widoczny dla zalogowanych], scattered parts of the corpus callosum with multiple small focal hemorrhage with diffuse axonal injury performance. Tip shear stress may be an important cause of intraventricular hemorrhage. In addition, the slow deformation of injury hurt the formation of transient negative pressure ventricle. Trauma causes the brain to the midline of the cutting sickle and so is the possible cause of intraventricular hemorrhage [41 complexity of traumatic intraventricular hemorrhage condition. With severe brain injury-prone. No specific clinical features. The importance of common symptoms and signs are: (1) disturbance of consciousness, coma or persistent after injury and then aggravated sexual coma occurred: (2) vital signs were changed to varying degrees: (3) signs of the nervous system: ① meningeal irritation; ② signs of nervous system orientation; ③ signs of brain stem injury; ④ body temperature. Should be used according to the specific conditions of early individualized treatment programs to reduce intracranial pressure, reduce secondary brain stem injury, in the active treatment of primary and secondary brain injury treatment on the basis of intraventricular hemorrhage. Lateral small amount of bleeding, could closely observe the condition of the foundation in the uplink conservative treatment. Repeated early lumbar puncture. The 5 cases of patients with intraventricular bleeding by conservative treatment and repeated lumbar puncture, were satisfied with the results: there is and the mass effect of intracranial hematoma and significant, should be OK hematoma evacuation,[link widoczny dla zalogowanych], make clear the surgery cerebral intraventricular hemorrhage in parallel outdoor drainage; double ventricle hemorrhage more, especially in the cerebral aqueduct, fourth ventricle obstruction, those who have blocked cerebrospinal fluid circulation, ventricle drainage lines should be timely, early drainage of bloody cerebrospinal fluid to reduce intracranial pressure. Reduce the incidence of hydrocephalus [51. Intraventricular hemorrhage and a large number of third and fourth ventricle via cerebral hemorrhage by injection of urokinase in an outdoor drainage tube to facilitate removal of intraventricular hemorrhage, and clear cerebrospinal fluid circulation, the lifting of hematoma on the surrounding deep tissue pressure: simple or double ventricle a small amount of unilateral hemorrhage who recovered well, the group of 5 patients were cured without any complications; degree of deep coma on admission, age,[link widoczny dla zalogowanych], intraventricular hemorrhage and more early stage of obstructive hydrocephalus associated with poor outcome: patients with severe diffuse axis cord injury, the prognosis is poor, this group of 15 cases 9 deaths in these patients, 2 cases of severe disability,[link widoczny dla zalogowanych], 4 patients in the residues. In addition, with the rapid development of minimally invasive neurosurgery for traumatic intraventricular hemorrhage. Endoscopic removal can also be applied intraventricular hematoma, endoscopic hemostasis, a higher value, need to be in the future study of the work