Objective:Toinvestigatetheclinicaltypingandprophylactico-therapeuticmeasuresforacuteposttraumaticbrainswelling(BS).Methods:Aretrospectivestudywasperformedin66casesofacuteposttraumaticBS.Therewere3groupsbasedoncomputeredtomography(CT)scanning:23casesofhemispherebrainswelling(HBS)withmiddlelineshiftforlessthan5mmwithin24hours(GroupA),20withmiddlelineshiftformorethan5mm(GroupB),and23withbilateraldiffusebrainswelling(GroupC).Results:(1)ThemortalityratesoftheoperativeandnonoperativemanagementinGroupA,GroupB,andGroupCwere20.0%,31.6%,and75.0%versus44.4%,0,and85.7%,respectively(P>0.05);whiletheratesinsubgroupswithdifferentmiddlelineshift(morethan5mmandlessorequal5mm)were29.2%and75.0%versus75.0%and44.4%,respectively(0.05>P>0.01).(2)ThegoodrecoveryrateandmortalityinGroupAwere47.8%and39.1%,respectivelyandinGroupC,8.7%and78.3%,respectively,TherewasaverysignificantdifferencebetweenGroupAandGroupC(P<0.01).(3)Thetotalsurvivalrateoftheselectivecomprehensivetherapywas53.1%.Conclusions：(1)AcuteposttraumaticBSneedstobediagnosedcorrectlyandpromptlywithCTscanningwithin4hours.(2)Forpatientswithmidlineshiftformorethan5mm,especiallywiththin-layeredsubduralhematoma,surgicalinterventionisessentialtoreducethefatalityofacuteposttraumaticBS.
