【摘要】 本文报告小脑幕切迹急性疝及慢性疝急性发作217例(简称切迹疝)。作者对其病因、病理改变、引起切迹疝的病变位置、辅助检查、治疗结果及预后作了较为详细的介绍。根据临床材料及切迹疝死亡患者脑标本检查,考虑切迹疝的临床表现与脑干机械性受压及椎—基底动脉系统循环障碍有关,病人的直接死亡原因与其合并枕大孔疝所致延髓受压及供血不足有关。因此,切迹疝病人的预后与脑干缺血时间长短、承受压力的大小关系密切。切迹疝继发脑干出血多见于年龄较大的患者。更多还原

【Abstract】 Two hundred and seventeen cases of acute herniation and attack of chronic her-niation of tentorium incisure(tentorial herniation)were reported.Their pathogenicconditions were extradural hematoma,contusion with or without hematoma,tumor,abscess and infection,hemorrhage of hypertention,hemorrhage of AVM and aneurysm,hematoma after operation,congenital heart disease with hemorrhage and chronicsubdural hematoma of frequency in order.The main symptoms of tentorial herniation included headache,vomiting,cons-cious disorders,dilated pupils,hemiplegia,changes in respiration and blood pressure,etc.The most important methods of diagnosis were angiography and CT.The posi-tion that was more apt to have tentorial herniation was temporal,tempo-parieto-fron-tal,parital,occipital and cerebellar occupition in order.The results of operation were as follows:162 were excellent,10 were neurologicaldeficit,45 were death(20.7%).The symptoms of tentorial herniation were considered to be related to the mecha-nical compression of the brain stem and the circulatory disorder of the vertebro-basilar artery.The direct cause of death was related to tonsillar herniation with comp-ression of the medulla oblongata and a reduction in blood supply in this area.There-fore,if the time of brain stem compression and its ischemia were short,the patientcould recover;and if it lasted long,irreversible damage might occur,in this case,even though the original lesion was removed.survival would still be difficult.Hemorrhage followed tentorial herniation in brain stem,which sometimes in theelderly.更多还原