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1 141 (DAI) 58 DAI CT 39 MRI 7519 %DAI ; ;7017 % ;CT 6318 % MRI CT ;DAI 8917 % ; 5315 % CT MRI DAI X ( diff use axonal injury DAI) (1515 %) 14 (2411 %) CT MRI DAI [1 2 ] (1211 %) 13 (2214 %) Cordobes [2 ] (816 %) 11 (1910 %) DAI 37 (6318 %) 16 (2716 %) DAI 19 ( 3218 %) 23 (3917 %) 17 (2913 %) % h h h CT 4 15 (4015 %) 7 (1819 %) 44 (7519 %) 2 (514 %) 5 (816 %) 3 (512 %) 13 (3511 %) 2 ( 315 %) 2 CT (315 %) 1 (117 %) 1 < 2 cm (117 %) (DBS) CT 3 1 GCS ; CT CT 18 CT (2214 %) 18 CT 7 (3110 %) 13 (2214 %) 4 MRI 39 3 (710061) 17 (2913 %) 9 21 (3612 %) 7 CT CT :6 h CT ; 7 转载

2 142 Table 1 CT results contrast with MRI Positive rate ( %) Manifestations Group Group Group ( n = 11) ( n = 7) ( n = 21) Region and quality CT 6318 Positive Positive Negative Mainly display DBS and hemor2 rhage foci in brain parenchyma ventriculi etc. MRI Same focus as CT More and larger focus Positive MRI is superior to CT in the detection of focal foci in deep parenchyma and brain axis 33 2 = P < 0105 compared with positive rate of CT CT 7 MRI 3 ; ; (CT 2 ; ; 1 ) 32 (6811 %) 1 (CT ) 2 (CT GOS : 3 1 DBS1 ) (CT DBS) ; 5315 % 1 21 CT ( %) MRI ; ; ; : 14 7 DAI T cm T 1 T 2 DAI [3 5 T 1 ] T 1 1/ 4 CT MRI DAI 1 ( Tab. 1) ; 1982 Gennarelli [3 ] DAI 52 (8917 %) 11 4 :11 ( 2 (7519 %) 1 ) 7 [2 4 5 ] 21 [6 ] 9 (9/ 11) 47

3 CT [9 ] [1 ] 21 CT MRI 13 (2214 %) CT MRI 41DAI [7 ] MRI DAI CT DAI :11 51DAI [6 8 ] 7017 % 61DAI 41 DBS DAI 51 DBS 61CT MRI : (1) Cordobes [2 ] DBS DAI 78 DAI 3/ 4 DBS < 2 cm (2) DBS 13 ( 2214 %) (3) 71 GCS 35 (4) DBS(5) CT %81DAI Cordobes [2 ] 4817 % (6) 5315 % CT 71 [1 2 DAI ] CT : ( 3 1 ) CT CT Levil [1 ] DAI CT 50 % 1/ 3 MRI CT [ ] MRI 1 Levi L Joseph N Guiburd J N et al. Diffuse axonal injury : analysis of 100 patients with radiological signs. Neurosurg : Cordobes F Rivas LJ Cabrera A et al. Post2traumatic dif2 fuse axonal brain injury : analysis of 78 patients studied with computed tomography. Acta Neurochirugica :27. 3 Gennarelli TA Thibault L E Adams J H et al. Diffuse axo nal injury and traurnatic comain in the primate. Ann Neurol : Adams J H Graham DI Gennarelli TA et al. Diffuse axonal injury due to nomissile head injury in humans : an analysis of 45 cases. Ann Neurol : Adams J H. Diffuse brain damage in humans and experimental head injury. Neurosurgeons : : :311

4 144 8 Graham DI Lawrence AE Adams J H et al. Brain damage in fatal non2missile head injury without high intracranial pres2 sure. J Clin Pathol :34. 9 Gentry L R Thompson B Godersky J C et al. Trauma to the corpus callosam : MR feature. AJ NR : Weisberg L Nice C. Cerebral computed tomography a tex2 tatlas. 3rd. Philadelphia : WB saunders compary ( ) ( : ) : : ; ; : : : ( ) cm ( : ) 2 ; ; 5 6 h 20 % 250 ml ( 7 ) 1 4 h ml/ d : CO mmol/ L BUN 2113 : mmol/ L ( 7 ) CO 2 BUN h 20 % : 125 ml 40 mg ml/ d ( 6 ) ( + ) ( 6 ) CO 2 17 mmol/ L [ 1 ] BUN 2512 mmol/ L 3 2 CO 2 BUN [ 2 ] : (463000) ( ) ) ( :

5 Chinese Journal of Nervous and Mental Diseases 23(3) May 1997 Clinical features and diagnosis of diffuse axonal in2 jury in head trauma1 Song Jinning L iu S houx un Ge Zhili et al1 Depart ment of Neurosurgery the First A f 2 f iliated Hospital Xian Medical U niversity 1 Health Road Xian (710061) 1 Tel : Objective To approach clinical features and diagno2 sis standard of diffuse axonal injury (DAI) 1 Methods Fifty2eight patients with DAI were examined by CT 39 cases were also received by MRI at same time1 DAI clini2 cal features were analysed1 Results 7519 % DAI was caused by traffic accidents The patients fell in persis2 tent coma immediately after the head injury1 There was no markly intracranial hypertension in patients of 7017 % DAI CT scanning showed unusual manifestation in 6318 % DAI1 MRI value was higher than CT scanning for DAI diagnosis 8917 % DAI focuses were located in the depths of brain and middle axial structure1 The prognosis of DAI was not well1 The mortality rate was 5315 %. Conclusions It was suggested that DAI clinical diag2 nosis standard may be formed based on clinical features the manifestation of CT scanning and MRI. Key words Brain injury Diffuse axonal injury CT scanning MRI Clinical diagnosis ( Chin J Nerv Ment Dis : ) A study on the comparision between the mental dis2 order related to superstitions or witchcrafts and hysteria1 Gong Zhuanpeng X u Hanming liu A nqiu W uhan Psychiat ric Hospital 70 Youyi Road Wuhan ( ). Tel : Clinical feature and treatment of traumatic intracra nial hematomas in old2aged patients1 He Qi Cheng Objective To study the clinical characteristics in the Guoxiong Cai Zhaoming1 The FirstA f f iliated Hospital mental disorder related to superstition or withcrafts1 of Guangz hou Medical College 151 Yan Jiang Road Methods Fourty2one cases of the mental disorders related to superstition or witchcrafts were analyzed and compared to 52 cases of hysteria with psychoscial stress (the control Guangzhou (510120) 1 Tel : Objective Investigation of the clinical feature and treatment of traumatic intracranial hematomas in old2aged group) 1 Results The average age at onset in the study group is older than in the control group1 There were significant differences in family history background of cul2 ture clinical symptom and possession state between two groups1 Conclusions The findings indicate that the mental disorder related to superstition or witchcrafts could be considered as one of the culture2bound syndromes1 The results of this study match with the Chinese classification and diagnostic criteria of mental disorders1 Key words Superstition or witchcrafts Hysteria Mental disorder Possession state ( Chin J Nerv Ment Dis : ) A new method of cranial defects repairment2traction and reposition of autogenous bone flap1 Gu Guoshan X u Qiw u M ao Ying et al1 Depart ment of Neurosurgery Hua S han Hospital S hanghai Medical U niversity1 12 Wulumuqi Zhong Road Shanghai (200040) 1 Tel : Objective To introduce a new method of cranio2 plasty which has not been reported before1 Methods From January 1995 to J une 1996 traction and reposi2 tion of autogenous bone flaps embedded under the scalp were underwent in 105 patients who needed external de2 compression by removal of bone flaps after craniotomy1 Locations of bone flaps used for traction and reposition were temporal lobe (38 cases) frontal lobe (30 cases) parietal lobe (23 cases) and occipital lobe (14 cases) 1 Dur2 ing the operation bone flaps were freed and preserved un2 der the scalp outside the bone windows1 After resolution of brain edema 1 2 weeks postoperatively traction and reposition of bone flap was underwent by stretching the silk threads which were previously fixed to the flaps1 Results Operative procedures of all patients were suc2 cessful and reposition of bone flaps was fine1 Conclu2 sions This new method has greatly changed the tradi2 tional cranial defect repairment by craniotomy and made it possible for the patients to undergo the external decom2 pression and cranioplasty at the same time and there is no need for the second operation1 This method has the advan2 tages of safty simplicity and few complications1 Key words Head injury Craniotomy Cranio2 plasty Traction Reposition ( Chin J Nerv Ment Dis : ) patients1 Methods 117 cases of traumatic intracra2 nial hematomas above 60 year old were reviewed1 Most of the patients were due to falls and motor vehicle accidents % of intracranial hematomas were countercoup hematoma and 2516 % mixed type1 87 patients were treat2 ed surgically and 30 patients underwent non2operative treatment1 Results Among 117 cases is : good re2 covery 4611 % mild disability 1218 % severe disability 413 % vegetative state 216 % and dead 3412 %1 Conclusions The factors such as depth of coma with or without brain herniation size and location of hematoma are closely related to the prognosis of patients1 The indication of the surgical and no2surgical treatments were proposed in this paper1 Critical care for the patients in preventing complication is important to decrease the mortality1