婴儿AVM致颅内出血的临床CT特点及预后

The characterists in clinical manifestation、CT and prognosis of cerebral hemorrhage from AVM in infants

目的 :探讨婴幼儿期AVM破裂出血的临床及头颅CT特点。方法 :回顾性分析 17例 1岁以内婴儿颅内AVM破裂出血的临床及影像学资料。结果 :全部病例以自发颅内出血为主要表现 ,常伴有癫痫发作、颅内高压、肢体瘫痪 ,CT检查提示血肿多位于脑内或浅部脑实质内 ,在血肿内或附近常可见异常血管影 ,伴发不同程度脑梗死是另一重要CT征象。结论 :婴儿颅内AVM破裂出血主要特点是自发性颅内出血 ,症状极不典型 ,易被误诊为晚期VitK缺乏症。临床表现及CT扫描是早期诊断的重要依据 ,积极微创手术治疗及防治出血后脑梗死有助于提高疗效 。

Objective: To discuss the characterists in clinical manifestation and CT of cerebral hemorrhage from arteriovenous malformationge in infants . Methods: To analyze retrospectly the clinical and CT data of 17 patients who are less than 1 year old with cerebral hemorrhage from AVM. Results: The main clinical manifestation is spontaneous intracranial hemorrhage accompany with epileptic seizure, high intracranial pressure and acroparalysis. In CT scanning, we find more hematomas site in intracerebrum and superficial cerebrum. Abnormal vasculature sign can be found in or near hematomas .Cerebral infarction is another important sign .Conclusion: The main characterist of cerebral hemorrhage from AVM in infants is spontaneous intracranial hemorrhage with atype manifestation. Therefore, it is easy to be misdiagnosed as deficiency of VitK1. Early correct diagnosis depend on clinical manifestation and CT scanning . Minimal invasive operations and prevention of cerebral infarction after hemorrhage are help for improving clinical outcome .