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创伤性脑血管损伤的诊疗现状及展望
阳源1△,李翯2△,方亦斌2,杨鹏飞2,刘建民2*
0
(1. 海军军医大学(第二军医大学)基础医学院学员二大队, 上海 200433;
2. 海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433
共同第一作者
*通信作者)
摘要:
创伤性脑血管损伤(TCVI)是创伤性脑损伤或颈部外伤后的并发症之一。TCVI发病率低,但其一旦发生,如果不加以干预,则有较高的致死、致残率。目前,研究者们明确了包括颅底骨折、颈椎损伤等在内的TCVI危险因素,并根据病理特征对其进行了初步分级。在TCVI的筛查与诊断方面,数字减影血管造影仍为金标准,而广受关注的计算机断层扫描血管造影的诊断效能有待商榷。在治疗方面,药物治疗、开放手术治疗和血管内治疗都被证明对特定类型的TCVI有较好效果。本文从上述角度展开,对TCVI的临床研究现状进行了综述,并对该领域未来的发展进行了展望。
关键词:  脑血管损伤  钝性创伤  危险因素  计算机体层摄影血管造影术  血管内治疗
DOI:10.16781/j.0258-879x.2021.02.0161
投稿时间:2020-11-03修订日期:2020-12-18
基金项目:
Diagnosis and treatment of traumatic cerebrovascular injury: current status and prospect
YANG Yuan1△,LI He2△,FANG Yi-bin2,YANG Peng-fei2,LIU Jian-min2*
(1. The Second Student Team, College of Basic Medical Sciences, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Stroke Center, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China
Co-first authors.
* Corresponding author)
Abstract:
Traumatic cerebrovascular injury (TCVI) is one of complications of traumatic brain injury and neck trauma. Although TCVI has a low incidence, it has high mortality and disability if not treated. Up to now, researches have identified a few risk factors of TCVI, including basilar fracture and cervical spine injury. A preliminary pathological grade of TCVI has been established based on the pathological features. Digital subtraction angiography is generally accepted as the golden standard in diagnosing and screening of TCVI, while the efficiency of computed tomography angiography, which is widely concerned, is still ambiguous. As for the treatment, drug therapy, surgery and endovascular treatment have been confirmed to be effective for specific types of TCVI. This paper reviews the clinical research status and prospects for the future.
Key words:  cerebrovascular trauma  blunt trauma  risk factors  computed tomography angiography  endovascular treatment