关键词：自发性脑出血；儿童；病因；治疗
摘要 目的：探讨小儿自发性脑出血的病因及其诊治方法的选择。方法：小儿自发性脑出血25例，多见于8～14岁，临床上癫痫发生率(44.0%)明显高于成人，部分患儿有贫血表现。病因以脑动静脉畸形(AVM)最常见(48.0%)，血液病(16.0%)次之，约1/4患儿病因不明。出血量大、病情进展快者宜急诊手术清除血肿，并及时行脑血管造影及全身系统检查明确病因、作相应治疗。小儿AVM采用血管内栓塞、手术切除或栓塞加手术切除。结果：治愈19例(76.0%)，好转3例(12.0%)，死亡3例(12.0%)。随访16例(1～6.5年)，1例死亡，1例再出血，余14例健康生存。结论：小儿自发性脑出血最常见病因是动静脉畸形和血液病，如诊断治疗及时，预后良好。
Causes and management ofspontaneous intracerebral hemorrhage in children Zhang Jianning, Zhang Xiang, Yi Shengyu, et al. Departmentof Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032
Abstract Objective: To investigate thecauses and treatment of the spontaneous intracerebral hemorrhage in children. Methods:Twenty-five patients in childhood (most of them were 8 to 14 years old) with spontaneousintracerebral hemorrhage (SICH) were presented. The main causes of SICH in children werebrain arteriovenous malformations (48%) and blood diseases (16%), but the causes in aboutone fourth of these cases were unknown. Early diagnosis and treatment of the originaldiseases and SICH are critical in management of these patients. Results: Nineteen caseswere cured, 3 cases were improved, and the other 3 cases died. Follow-up studies (16 casesfor 1 to 6.5 years) indicated that 14 patients were satisfactorily recarperated, one had rehemorrhage, and one died. Conclusion: The most comman causes of the SICH in children arearteriovenous malformation and blood disease. The outcome of these patients is good ifdiagnosed and treated on time.
Key words Spontaneous intracerebralhemorrhage Children Etiology Management
小儿自发性(非外伤性)脑出血较少见 ......
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