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以往脑干损伤诊断多仅凭病史和神经体系统格检查,缺乏客观的辅助检查。利用影像学和电生理学技术可从形态学、组织代谢和神经功能等多方面对脑干损伤进行客观的诊断和预后分析。研究认为,CT检查是颅脑损伤的首选检查,对较大的出血性脑干损伤有直接诊断作用,对非出血性脑干损伤多通过间接征象诊断。核磁共振检查是脑干损伤最理想的检查,MRI各序列可反映脑干损伤的形态学改变,通过分类研究发现,患者预后与脑干损伤部位关系密切。1HMRS从组织病理代谢变化角度能解释更多伤后昏迷而形态学检查无法解释的脑干损伤,有诊断分类和预后作用。神经诱发电位是最简便、可反复在床旁进行诊断和监测的检查方法,能从神经功能损伤的角度对脑干损伤进行定位诊断和预后分析,与MRI研究结果相吻合。
In the past, diagnosis of brain stem injury was mostly based on medical history and neurosurgical examination, lack of objective auxiliary examination. Using imaging and electrophysiology techniques, we can make objective diagnosis and prognosis analysis of brain stem injury from the aspects of morphology, tissue metabolism and neurological function. Studies suggest that CT examination is the preferred examination of head injury, a greater diagnosis of hemorrhagic brainstem injury has a direct role in the diagnosis of non-hemorrhagic brain stem injury by indirect signs and more diagnosis. MRI is the most ideal examination of brain stem injury, MRI sequences reflect the morphological changes of brain stem injury, the classification found that the prognosis of patients with brain stem injury is closely related. 1HMRS can explain more brain injury caused by postoperative unconsciousness and unexplained morphological changes from the perspective of histopathological metabolism, with the diagnostic classification and prognosis. Nerve evoked potentials are the most simple and can be repeated in the bedside diagnosis and monitoring of the inspection method, from the perspective of neurological damage brain damage diagnosis and prognosis of brainstem analysis, consistent with the MRI findings.