Idiopathic delayed brain swelling after head injury:a clinical analysis of 28 cases

DONG Chaofeng; LI Liang; FU Luoan

Abstract：Objective The features of onset and preventive treatment of idiopathic delayed brain swelling after head injury are investigated.Methods Clinical data of 28 cases of idiopathic delayed brain swelling after head injury admitted to our hospital from August 2006 to August 2013 were analyzed retrospectively.Results All the patients were followed up for 6~12 months.According to GOS grading, there were 26 cases of good recovery (92.9%) and 2 dead cases with the mortality of 7.1%.Conclusion Delayed brain swelling usually occurs in frontal and temporal lobe contusion with subarachnoid hemorrhage, subdural thin layer of hematoma and early CT with mild brain swelling. The pathogenesis may be related to the delayed cerebral vasospasm post-trauma, the microcirculation disturbance, the disturbance of venous flowing, the decline of mannitol function and the other factors.Because of the insidious and sudden onset of the disease and sudden worsening after improvement for 7 ~10 d, the mortality is very high. Therefore, the early effective intervention and the prevention are the keys to reduce the complications, mortality and morbidity.