青中年期自发性脑干血肿的诊治

The Diagnosis and Treatment of Spontaneous Hematoma of Brain Sterm in Youths

本文报告13例自发性脑干血肿,对其发病年龄,临床表现、神经放射检查,特别MRI及MRA的诊断价值以及治疗选择,γ-刀治疗等问题作了较深入的分析。脑干血肿好发青壮年,原因多系脑血管畸形,常有反复出血史,通过神经放射检查,特别是MRI和MRA对脑干血肿诊断的特异价值,可得出比较明确的诊断,而X-CT对诊断帮助不如MR,脑血管造影对诊断几乎没有帮助。治疗上考虑到大部分病人为青壮年,临床表现轻,既要防止致命的再出血,又要避免致残。故本组对6例自发性脑干血肿,疑仍有原发病灶的病人行γ-刀治疗,取得满意效果,值得推广。

13 patients with spontanous hematoma of brain stem were reported, The age of onset, clini-cal manifestations, neuroradiological examination, especially the diagnostic value of MRI and MRA, the choice of treatment and the treatment with r-knife had been investigated. The hematoma occurs commonly in youths. It is caused mainly by AVMs and has the history of recurrent bleeding. MRI and MRA have the specific value in the daignosis of brain stem hematoma. They can confinn the diagnosis X-ray and CT have no specific value in diagnosis. Angiography is almost of no use to diagnosis, Most patients were young and the clinical features were mild in order to prevent rebleeding and deformity, 6 patients with spontaneous hemtoma in brain stem, who were suspected to have primary lesion, were treated with r-knife. The effects were satisfactory. The author suggested that this mathod of treatment is preferred in this disease.