慢性扩展性脑内血肿的临床病理特征及诊治分析

Clinicopathological features and diagnosis and treatment for chronic expanding intracerebral hematoma

目的探讨慢性扩展性脑内血肿（CEIH）的发病机理、临床病理特征及诊治要点。方法回顾性分析9例经手术确诊的CEIH病人的临床病理及影像学资料，均行骨瓣开颅显微镜下病灶切除术。结果9例病人均达显微镜下病灶全切除。病理结果显示：动静脉畸形1例，血管瘤1例，余未见异常血管。术后症状完全消失6例，余均明显缓解。随访3个月一1年，均无复发。结论影像学检查类似肿瘤出血而临床呈反复发作、慢性扩展特征的病例，应考虑CElH的可能，手术全切除是其首选治疗方法。

Objective To explore the pathogenesis, clinicopathological features and key points for diagnosis and treatment of chronic expanding intracerebral hematoma （CEIH）. Methods Clinieopathological and imaging data of 9 patients with CEIH diagnosed by operation were analyzed retrospectively. The patients underwent craniotomy and lesion resection under microscope. Results Total lesion resection was achieved in 9 patients under microscope. The pathological results revealed arteriovenous malformation in 1 patient, hemangioma in 1 and no vascular abnormality was seen in other patients. The symptoms completely disappeared postoperation in 6 patients and relieved in 3. No patient recurred during a follow-up period of 3 months to 1 year. Conclusions The intracerebral shadow similar to tumor hemorrhage in imaging with recurrent attacks and chronic expanding should be considered CEIH, and total resection is the first choice of treatment for CEIH.