河南大学外科学颅脑损伤

2. Incomprehensible
response
sounds
2. Extension to pain
3. Inappropriate words
4. Confused words
3. Flexion to pain
l Withdrawal from pain
l Appropriate verbal l Localizing to pain
2008 published by Farrar, Straus and Giroux
颅脑损伤的方式
1.直接损伤
①加速性损伤（着力伤） ②减速性损伤（对冲伤） ③挤压伤
2.间接损伤
①垂直落地：可引起脊柱骨折和颅底骨折、脑损伤 。 ②外力作用于躯干：挥鞭伤。 ③胸部遭受突然挤压：创伤性窒息。
Glasgow Coma Score
people with TBI) • 80,000 Americans obtain a long-term disability following
TBI every year • 2 3 of firearm related TBI’s are a result of someone trying to
Incidence Rates
• Currently 5.3 million Americans are living with a disability as a result of TBI (about 2% of US population)
• 1.5 million Americans sustain a TBI each year • More than 50,000 people die each year from TBI (22% of
attempt suicide • The risk of TBI in men is twice the risk in women • Every 21 seconds, one person in the U.S. sustains a TBI
Comparing TBI
2,000,000
1,500,000 1,000,000
responses
1. Obeys commands
Glasgow 昏迷评分
运动反应
计分 语言反应
按吩咐动作
6
正确
定位反应
5
不当
屈曲反应
4
错乱
过屈反应（去皮层） 3
难辨
伸展反应（去脑） 2
不语
无反应
1
计分 5 4 3 2 1
睁眼反应 计分 自动睁眼 4 呼唤睁眼 3
刺痛睁眼 2 不睁眼 1
轻型：13~15，中型：9~12，重型：3~8
颅脑损伤
2015年9月
概述
颅脑损伤（craniocerebral injury） 平时多见于交通事故、 高处坠落伤，战时多因火器伤造成，其死亡率和致残率居身 体各部位损伤之首。
Definition of TBI
• An insult to the brain, not of degenerative or congenital nature caused by an external physical force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning.
Money!!!!
• 48.3 billion dollars annually spent in the U.S. for patients with TBI
– Hospitalization accounts for 31.7 billion dollars – Fatal brain injuries cost the U.S. 16.6 billion dollars
Eye Response
1. No eye opening 2. Eye opening to
pain 3. Eye opening to
verbal command l Eye opening
spontaneously
Verbal Response MotorResponse
1. No verbal response 1. No motor
Detroit……...
….Seven of these cities are filled already. A third of their citizens are under fourteen
years of age.”
From Head Cases, Stories of Brain Injury and its Aftermath Michael Paul Mason
Head Injury-Anatomy
• Scalp • Blood supply • Calvaria • Brain
– Occupies 80% of calvarium
二、头皮损伤
1.皮下血肿。
2.帽状腱膜下血肿（subcutaneous hematoma）。较大，可延 及全头，不受颅缝限制，触之软，有波动。在婴幼儿可引 起贫血甚至休克。
Annual Incidence百度文库
500,000
0
Traumatic Breast
Brain
Cancer
Injury
HIV/Aids
Spinal
Cord Injury
Pie Chart of TBI Causes
Transportation 44% Falls 26% Other 13% Firearms 8% Non Firearm Assaults 9%
“Reframed, the numbers nauseate. In America alone,
so many people become permanently disabled from a brain injury that each decade they could fill a city the size of