Midline shift after severe head injury: pathophysiologic implications.

摘要: Objective: To investigate the mechanism of adverse effect midline shift after severe traumatic brain injury. Methods: This study compared averaged cerebral metabolic parameters patients with > 5 mm (S) on initial computerized tomography scan to those ≤ (NS). The an acute subdural hematoma (SDH) was determined by separating into and without SDH then re-examining in these subgroups. Results: Four hundred fifty-four were studied. Cerebral rate oxygen (CMRo 2 , mL/100 g per min) always lower shift: 1.74 for SDH-S versus 2.21 SDH-NS (p < 0.001), 1.80 non-SDH-S 2.24 non-SDH.NS 0.001). No other major effects seen patients. Among non-SDH patients, associated higher intracranial pressure (ICP): 23.1 Hg 16.3 Other differences between nonshift group due at least part interventions treat elevated ICP. Conclusion: Midline injury is reduced CMRo regardless whether or not present. deleterious blood may be related more mass large SDHs than biochemical abnormalities caused small amounts space.