老年不典型脑出血180临床分析

目的:探讨老年不典型脑出血的临床特点,避免临床误诊。方法:收治脑出血患者180例,进行回顾性分析。结果:有明确病因132例(73.3%),其中高血压病100例,动静脉畸形24例,其中Moyamoya病3例,动脉瘤9例,海绵状血管瘤12例,均经DSA确诊。髓母细胞瘤2例,星形胶质细胞瘤2例,均经术后病理确诊。肾病综合征2例,白血病4例,原发性血小板减少紫癜2例。病因不明48例(26.7%)。出血量8.5～80ml,平均48.6ml。其中大脑半球出血106例(58.9%),蛛网膜下腔出血42例(23.3%),小脑出血32例(17.8%)。结论:不典型脑出血的首发症状多有头晕、头胀、头部不适感或眩晕,临床症状多种多样,容易误诊。

Objective：To investigate the elderly is not a typical clinical features of intraeere- brd hemorrhage to avoid misdiagnosis. Methts ：The hospital in March 2010 - December 2011 in our hospital 180 cases of cerebral hen）orrhage were analyzed retrospectively. Resuhs：There were 132 cases of a clear cause, accounting for 73.3% ,of which hypertension： 100 cases of arleriovenous malformations in 24 eases, including three cases of Moyamoya disease ,aneurysm in 9 cases ,cavernous hemangioma, 12 cases were confirmed by DSA. Two cases of meduiloblastoma, astroeytoma,2 cases were confirmed by pathological diagnosis. Nephrotic syndrome in 2 cases,4 cases of leuke- mia,idiopathic thrombocytopenic purpura in 2 cases. 48 cases of unknown etiology, accounting for 26.7%. Bleeding 8.5 -80m] ,mean 48. 6m]. One cerebral hemisphere hemorrhage, 106 cases accounting for 58. 9%, subaraehnoid hemorrhage ,42 cases ,accounting for 23.3% of cerebellar hemorrhage in 32 cases ,accounting for 17. 8%. Conclusion： not a typical first symptoms of cerebral hemorrhage with dizzi- ness, stretching,head discomfort or dizziness, a variety of clinical symptoms, easily misdiagHosed.