Objective To analyze the clinical features and CT findings of mild traumatic brain injury patients with sudden death. Methods A total of 15 mild traumatic brain injury patients with sudden death were selected in the Affiliated Hospital of Hebei Engineering University from 1995 to 2007,and their clinical data was retrospectively analyzed,clinical features(causes of injury,duration between injury and death,exacerbation manifestations)and CT findings were summarized. Results Causes of injury:12 cases with traffic accident( accounting for 79. 9% ),1 case with fall damage after drinking (accounting for 6. 7% ),1 case with strike injury( accounting for 6. 7% ),1 case with building operations related injury (accounting for 6. 7% );duration between injury and death:7 cases within 12 hours( accounting for 46. 7% ),4 cases between 12 to 24 hours(accounting for 26. 6% ),2 cases between 1 day to 2 days(accounting for 13. 3% ),1 case on the fifth day( accounting for 6. 7% ),1 case on the ninth day( accounting for 6. 7% );exacerbation manifestations:8 cases with sudden dysphoria and convulsion( accounting for 53. 3% ),6 cases with conscious disturbance( accounting for 40. 0% ),2 cases with nausea,emesis,coma and gatism( accounting for 13. 3% ),1 case with sudden breath and heart beat arrest (accounting for 6. 7% ). The first CT examination results:6 cases with kull parietal bone fracture(accounting for 40. 0% ),1 case with basilar skull fracture(accounting for 6. 7% );injury types:8 cases with contusion and laceration of frontal lobe and temporal lobe(accounting for 53. 3% ),5 cases with intracranial hematoma of frontal lobe and temporal lobe or subdural hematoma(accounting for 33. 3% ),5 cases with subarachnoid hemorrhage(accounting for 33. 3% ),2 cases with intracranial pneumatosis(accounting for 13. 3% );CT characteristic features:5 cases with stenosis or disappearance of surrounding brain pool(accounting for 33. 3% ),9 cases with compression and translocation of ventricle(accounting for 60. 0% ). Conclusion Traffic accident is the major cause of mild traumatic brain injury patients with sudden death,most of them keep clear consciousness without positive signs of the nervous system at admission,but the state of an illness may suddenly exacerbate;the common injury types includes contusion and laceration of frontal lobe and temporal lobe,intracranial hematoma and subarachnoid hemorrhage;the main CT findings includes stenosis or disappearance of surrounding brain pool,compression and translocation of ventricle.%目的 分析轻型颅脑损伤突然死亡患者的临床表现及CT表现.方法 选择河北工程大学附属医院1995—2007年收治的轻型颅脑损伤突然死亡患者15例,回顾性分析患者的临床资料,总结其临床表现(包括损伤原因、损伤至死亡时间、病情恶化表现等)及CT表现.结果 损伤原因:车祸伤12例(79.9%),酒后摔伤1例(6.7%),打击伤1例(6.7%),建筑施工伤1例(6.7%);损伤至死亡时间:12 h内7例(46.7%),12~24 h 4例(26.6%),1~2 d 2例(13.3%),第5天1例(6.7%),第9天1例(6.7%);病情恶化表现:突然出现烦躁抽搐8例(53.3%),意识障碍6例(40.0%),恶心、呕吐、昏迷、大小便失禁2例(13.3%),呼吸、心搏骤停1例(6.7%).首次CT检查结果:颅顶骨骨折6例(40.0%),颅底骨折1例(6.7%);损伤类型:额颞叶脑挫裂伤8例(53.3%),额颞叶颅内或硬膜下血肿5例(33.3%),蛛网膜下腔出血5例(33.3%),颅内积气2例(13.3%);CT特征表现:周围脑池变窄或消失5例(33.3%),脑室受压移位9例(60.0%).结论 轻型颅脑损伤突然死亡患者损伤原因多为交通事故,多数患者入院时意识清楚,无神经系统阳性体征,而入院后短时间内病情突然恶化;主要损伤类型为额颞叶脑挫裂伤、颅内血肿及蛛网膜下腔出血,主要CT表现为周围脑池变窄或消失、脑室受压移位.
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