The Significance Of The Lateral Ventricle Before The Angle Change In The Bilateral Frontal Lobe Contusion Treatment

Background:With the rapid socio-economic development and transportation, traumaticbrain injury (Traumatic brain injury, TBI) incidence increased year by year, iscurrently the ninth largest cause of death factors, WHO believes that2020accident caused traumatic brain injury will be listed in the top three causes ofdisease burden[1]. Especially severe traumatic brain injury, has become a lethalinjuries, leading causes of disability, the literature reports accounted for severetraumatic brain injury traumatic brain injury20%[2]. U.S. Centers for DiseaseControl data show that the annual incidence of traumatic brain injury andhospitalization rates were403/100,000and85/100,000[3,4],23countries of theEuropean findings are as follows: traumatic brain injury incidence rate of about235/100,000, with an average mortality rate of about15/10people[5], andAustralia similar. In China, at least70million people annually injuries occur more than once, which killed80people,200people left varying degrees ofdysfunction,90million people with lifelong disabilities. Injury deaths in ourpopulation mortality statistics, from the early1950s, jumped to ninth place fifthin the1990s, with an estimated2030China will have250million people diedfrom injuries caused by the premature death[6]. The frontal lobe contusion is aTBI special case of the more, the development of hiding, changing very rapidly,often due to too late to rescue and lead to serious consequences, frontalcontusion patients with early level of consciousness tends to be relatively mild,often to non-surgical treatment, but with the condition changes, occult graduallyincreased intracranial pressure, resulting in the diencephalon, midbrain, ponsand medulla oblongata were successively downward pressure axial displacementof the center of the formation of brain herniation, the patient once Brain Centerhernia occurs, the general prognosis is extremely poor and often life-threatening.Methods:This study is from March2011to February2013to our hospital, andthrough the head CT examination, the diagnosis of frontal lobe contusionpatients for the study.66patients were selected into the gender composition of52males and14females, aged between15-81years old, with an average age of 46.41years, traffic accident in32cases, seven cases fall injury, pummelinginjury in9cases, combat injuries in18cases, Glasgow Coma Score (GCS)between3to15points,13to15minutes in32cases,9to12points in13cases,3to8points in21cases, including choice of surgical treatment of15cases,conservative Treatment of51cases. After a review of relevant literature andreports ventricle degree angle change and disease progression in patients withfrontal lobe contusion and whether the occurrence of cerebral hernia centerclosely. We ventricle changes the angle selection operative time, more timelyrescue the lives of patients. Ventricle angle measurement methods: conventionalhead CT scan slices, the upper level of the third ventricle was measureddimension to the corpus callosum anchored to the anterior horn of the lateralventricle cited bilateral tangent is the angle between the two tangents ventricleangle.Results:By ventricle angle measurement method, was elected to the66cases forpatients with frontal lobe contusion measurements found that when the ventricleangle>120o when the cerebral centers hernia patients in this group, a total ofseven cases this kind of disease. The remaining patients ventricle angle at 100o~120obetween.Conclusion:In this study, by measuring the number of angles folder ventricle followingconclusions:1. Pair of frontal lobe contusion patients, when the angle is greaterthan120o ventricle occurs when the brain centers significantly higher risk ofhernia.2ventricle closer angle120o, the more severe clinical symptoms, herniaoccurs the greater the likelihood of brain centers, should be combined with GCSscore and related imaging (Central pool, three ventricle morphology), to decidewhether surgery.3ventricle angle values and intracranial pressure monitoring ofICP values have relevance in the treatment of patients with dual frontalcontusion has certain guiding significance.4ventricle angle measurement issimple, convenient, easy, do not have intracranial pressure monitoring and otheradvanced equipment of the hospital, you can measure this angle, combined withthe clinical manifestations of patients with frontal lobe contusion surgeryprovide the basis for timing.