Abstract:

Supratentorial and infratentorial combined injuries is a rare but particularly type of severe traumatic brain injury (sTBI), characterized by high rates of morbidity and mortality. The injury spans the tentorium of cerebellum, involving key structures such as the supratentorial cerebral hemispheres, the infratentorial cerebellum and brain stem. Its pathophysiological mechanism is complex, progression is rapid, and diagnosis and treatment are extremely challenging. Currently, there is no unified clinical consensus established for its management, either domestically or internationally. This article systematically reviews recent research advances in the pathophysiological basis, injury characteristics, clinical manifestations, diagnostic evaluation, treatment strategies, and perioperative management of supratentorial and infratentorial combined injuries, aiming to provide a basis for clinical diagnosis and treatment.

Key words: Brain injuries, traumatic, Tomography, X-ray computed, Magnetic resonance imaging, Intracranial pressure, Neurosurgical procedures, Perioperative period, Review

摘要：

幕上幕下联合损伤作为重型颅脑创伤中发生率较低, 病残率和病死率较高的特殊类型, 其损伤范围跨越小脑幕, 累及幕上大脑半球、幕下小脑、脑干等关键解剖结构, 病理生理学机制复杂、进展迅速, 诊断与治疗难度极大, 目前国内外尚未形成统一的临床路径。本文通过系统阐述幕上幕下联合损伤的病理生理学基础与损伤特点、临床表现与诊断评估、外科手术策略与围手术期管理进展, 为疾病的临床诊断与治疗提供依据。

关键词: 脑损伤, 创伤性, 体层摄影术, X线计算机, 磁共振成像, 颅内压, 神经外科手术, 围手术期, 综述