神经外科的医学英语摘抄.doc

All patients underwent a Computed Tomography (CT) scan. In five patients the CT-scan did not only show a hyperdense subdural bleeding, but also collections of mixed densities. 所有病人都接受CT扫描，有5例病人CT不仅显示硬膜下高密度出血，还可见到混杂密度。Notably, patients 4 and 5 were the only patients that were not comatose on admission. Six of the 7 comatose patients showed pupillary abnormalities. The mean Glasgow Coma Sum Score (GCS) on admission was 7.7.值得注意的是，4、5两例 病人是在入院时没有昏迷的，7个昏迷病人中有6个发现有瞳孔异常。入院时GCS评分平均为7.7。In four patients an emergency craniotomy was carried out. A bleeding cortical artery was found in two patients bridging veins. 有四例患者接受了急诊开颅手术，在两例桥静脉损伤病人中有一例发现了皮层动脉出血。Patient 4 was treated conservatively because the only clinical sign was confusion and the subduralhaematoma was thin. 病例4接受了保守治疗，因为他的临床体征不典型（杂乱），而且硬膜下血肿薄（量少）。The other four patients were in a neurological condition considered too poor to continue any treatment. 另外四例患者神经系统情况太差而不能继续接受治疗。Five of the nine patients died. 9例患者中有5例死亡。The mean Glasgow Outcome Score (GOS) at discharge was 2.1. 出院时GOS（格拉斯哥预后评分）平均为2.1。This group consists of one woman and two men with a mean age of 73.3 years.Two of them were known with arterial hypertension. Two patients complained of headaches for some days prior to the acute stage.The onset of symptoms was sudden in all three.Only one patient deteriorated to coma and had one mydriatic pupil.On examination she had a mild dysphasia and a paresis of the right arm.An angiography was performed in patient 12 and an aneurysm was ruled out.An evacuation through burr holes was performed twelve days after the acute event and she remained symptomfree.Of the other two patients, one died and one had a good recoveryTwo patients in both groups complained of persisting headache preceding the acute stage.Three patients in the coagulopathy related group and two in the non-coagulopathy related group had a known history of arterial hypertension.The mortality rate was 55,6% in the coagulopathy associated group, versus 33,3% in the non-coagulopathyrelated group.As a far as we know, only one patient has been reported with spontaneous resolution of symptoms and who did not need an emergency craniotomy.Surgical repair of aneurysms, traumatic injuries, or congenital anomalies of the thoracic aorta are associated with high morbidity and mortality mainly as a result of excessive and uncontrollable hemorrhage from diffuse coagulopathy.Tables 1 and 2 list all the necessary drugs, materials, and equipment needed for carrying out the procedure.The animal was placed in the right lateral decubitus position, prepared, and draped.Chronic subdural haematoma (CSH) is a common lesion in neurosurgery and usually associated with a low rate of morbitidy and mortality in most casesNevertheless, there are some patients with poor outcome, especially those with a history of coagulopathy or ethylism.Our study group consisted of 114 patients (69 males, 45 females) with age ranging from 14 to 91 years (median 65 years).The treatment remained conservative in five cases.No operation (n=5) was performed for different reasons: one patient rejected surgery, one CSH was not space-occupying, and three elderly patients were in a poor clinical condition (Karnofsky score less than 30).The correlation of coagulopathy and pupillary light reflex, the degree of midline shift in brain computer tomography and Glasgow outcome scale (GOS) after head injury were prospectively evaluated.The incidence of abnormal coagulation following head injury in non-survival cases was 100% and in survival cases 66%.The presence of fixed pupil is defined as unresponsive (1 mm) to a light stimulus. The pupillary light reflex was divided into three categories including one pupil fixed, both pupils fixed and both pupils reactive.The outcome of the patients at discharge was categorized according to the Glasgow outcome scale,14 as: (1) death; (2) persistent vegetative state; (3) severe disability (conscious but disabled); (4) moderate disability (disabled but independent) and (5) good recovery.The most common type of brain injury was subdural hemorrhage 37.7% (23/61), followed by traumatic subarachnoid hemorrhage 22.9% (14/61).A total of 11 patients (six male and five female; mean age: 39.513.1 years) died. The GCS score of these patients were averaging 4.32.0 and CS 6.63.5 (Table 9).Most mortality occurred in patients with both pupils being fixed, brain CT midline shift P15 mm and coagulopathy scores P4.Continued bleeding leads to shock, characterized by hypoperfusion, hypothermia, and acidosis. These conditions worsen coagulopathy and lead to additional bleeding, which in turn worsens shock. 连续的出血导致休克，特点是血流灌注不足、低体温和酸中毒。这些情况进一步恶化凝血紊乱并引起继续出血，从而使休克加重。Similarly, nine patients received FVIIa as treatment for life-threatening hemorrhage in the presence of coagulopathy from prescription use of warfarin. Elderly patients who are taking warfarin are at high risk for mortality after traumatic brain injury. 同样的，有9例患者接受FV