儿童期自发性颅内出血44例临床分析

Spontaneous intracranial hemorrhage in childhood A report of 44 cases

目的 探讨儿童期自发性颅内出血的发病率、病因、临床特点及诊断治疗。方法 通过对 44例患儿的临床分析 ,尤其是CT和脑血管造影所见 ,以阐明其特点。结果 儿童期自发性颅内出血病因以脑动静脉畸形 (AVM )多见 ,占 2 5 / 44。临床特点主要表现为头痛、呕吐、意识障碍、抽搐和偏瘫。出血部位多在脑叶 ,占 2 3/ 44。数字减影脑血管造影 (DSA)是确定病因最有效的方法。血肿清除加AVM切除术是有效的治疗方法。结论 AVM是儿童期自发性颅内出血的主要原因 ,DSA是确诊AVM的可靠方法。

Objective To investigate the incidence, causes,clinical characteristics, diagnosis and treatments of spontaneous intracranial hemorrhage (SIH) in childhood. Methods The manifestations, CT scan and cerebral angiography of 44 cases with SIH were reviewed. Results The most common cause of SIH was cerebral arteriovenous malformation (AVM 25/44).The clinical presentations were headache, vomiting, disturbance of consciousness, convulsion and hemiparalysis. Most of the hemorrhage was located in the lobar (23/44). CT examination could confirm the site and amount of hemorrhage. DSA was the best method to demonstrate the cause of SIH. Hemorrhage clearance and AVM removal were the effective treatment. Conclusions AVM is the main cause of SIH in children. DSA is a reliable method to confirm the diagnosis.