135例青年脑出血CT、DSA及病因分析

目的探讨非高血压性青年脑出血的病因。方法分析135例非高血压性青年脑出血患者的CT、DSA资料。结果脑叶出血64例，基底节区出血33例，脑室出血29例，小脑出血9例DSA正常55例（占40．7％），异常80例（占59．3％），其中烟雾病43例、动-静脉畸形（AVM）29例、动脉瘤6例、动-静脉瘘2例。8例复发性脑出血中DSA正常5例。结论烟雾病是非高血压性青年出血重要原因．其出血的好发部位是基底节区和脑室；隐匿性血管畸形也是非高血压性青年脑出血原因之一；基底节区和脑室出血DSA阳性率比脑叶出血高。

The Cheracteristics of CT,DSA and Pathogeny in One Hundred and Thirty-five Young People with Cerebral Hemorrhage

Objective To explore the pathogeny of cerebral hemorrhage without hypertension in young people.Methods The data of CT and DSA were analyzed retrospectively in one hundred and thirty-five young patients with cerebral hemorrhage without hypertension in our hospital.Result In these cases,the positions of hemorrhage of 64 patients were in lobe of brain;that of 33 patients was in basal ganglia;that of 29 patients was in cerebral ventricle and that of 9 patients was in cerebellum.DSA of 55 patients was normal(40.7%).DSA of another 80 patients was abnormal,among them 43 cases were Moyamoya disease,29 were A-V malformation,6 were aneurysm and 2 were A-V fistula.In 8 patients with recrudescent cerebral hemorrhage,DSA of five of them were normal.Conclusion Moyamoya disease is an important reason of hemorrhage in young people without hypertension and most positions of hemorrhage are basal ganglia and cerebral ventricle;Cryptic arteriovenous malformation is also a reason of hemorrhage of young people without hypertension.The rate of abnormal DSA is higher in patients whose hemorrhage in basal ganglia and cerebral ventricle than in lobe of brain.