Diagnosis and treatment of 23 cases of cerebral infarction after craniocerebral trauma

Objective To analyze and summarize the pathogenesis of craniocerebral trauma complicated with cerebral infarction and effective preventive measures and individualized comprehensive treatment plan to improve the therapeutic effect and reduce the mortality and morbidity. Methods Twenty-three patients of merger of cerebral infarction after craniocerebral trauma in our hospital from December, 2011 to November, 2016 were selected as the research object. In this group, there were 13 cases of serious brain contusion, for the patients with intracranial hematoma combined elevated intracranial pressure or cerebral hernia, the drilling hematoma drainage or craniotomy hematoma removal was performed (including decompressive craniectomy in 6 cases). There were 2 cases of cerebral infarction after traumatic brain injury, the cerebral angiography was performed to confirm the cerebral infarction that was caused by thrombosis after trauma, and active thrombolysis intervention was given. There were 8 cases of cerebral infarction with stable condition, lighter brain contusion or small intracranial hematoma, without significantly elevated intracranial pressure, the conservative methods of internal medicine was administrated. All the patients in this group received calcium antagonists, free radical scavengers and other drugs; the early limited fluid resuscitation and late active fluid resuscitation, early hyperbaric oxygen and rehabilitation therapy were performed in patients with traumatic hemorrhagic shock. Individualized comprehensive treatment was carried out, and the therapeutic effect was observed. Results Among the 23 cases of craniocerebral trauma combined with cerebral infarction patients, according to Glasgow Outcome Scale (GOS) standard evaluation after active rescue, 14 cases recovered well, mild disability in 6 cases, severe disability in 1 case, and 2 cases died; of those who died, 1 died of traumatic hemorrhagic shock, 1 died of multiple organ dysfunction syndromes (MODS). Conclusion Early prevention and diagnosis, timely diagnosis of the cerebral infarction after craniocerebral trauma, and positive and effective early individualized comprehensive treatment can effectively reduce the mortality and morbidity.