目的了解外伤后局部脑水肿发生发展的动态变化的规律。方法选择本院1998～2002年进行过多次头部CT扫描的脑外伤病人120例,记录每次CT扫描多项影像学及相关临床指标,并对这些指标进行统计分析。结果本组96.7%的病人CT上显示局部水肿,水肿多在伤后7h出现,9d达到水肿高峰,其形态有向圆锥形发展的趋势,并有皮层回避的特点。结论外伤后局灶性脑水肿普遍存在。灰质和白质在组织结构、血供等方面的差异可能是引起水肿圆锥形态和皮层回避的原因。了解这些规律对于预计水肿的发展趋势,指导临床治疗有重要意义。 Objective To understand the dynamic changes of local brain edema after trauma. Methods 120 cases of traumatic brain injury were performed in our hospital from 1998 to 2002, and multiple imaging and related clinical indexes of each CT scan were recorded. Statistical analysis was made on these indexes. Results In this group, 96.7% of the patients showed local edema on CT. Edema occurred mostly at 7h after injury, and reached the peak of edema on the 9th day. The morphology of the edema tended to conical, and there was a characteristic of cortical evasion. Conclusion Focal brain edema is common after trauma. Differences in the histological structure, blood supply, etc. between gray matter and white matter may be responsible for the conical morphology of edema and cortical evasion. Understanding these rules is of great significance for predicting the development trend of edema and guiding clinical treatment.