脑动静脉畸形破裂脑内出血59例分析

目的探讨在基层医院脑血管造影条件不完善情况下脑动静脉畸形破裂出血的诊断及治疗。方法对59例脑动静脉畸形破裂出血患者与同期收治的174例高血压脑出血患者从年龄、血肿部位及形态、出血后血压变化及应用甘露醇是否有效几方面作回顾性对比分析。结果我们发现脑动静脉畸形出血患者平均年龄低，出血部位多在皮层下，形态不规则，呈弧形凹入或尖角形，出血后血压正常或一过性收缩压增高，用甘露醇后可下降。结论在基层医院，无脑血管造影条件下，脑动静脉畸形出血术前可根据患者年龄、出血部位、血肿形态，以及出血后血压升高用甘露醇是否有效做出初步判断，术中多数可确诊。治疗上需根据患者意识情况和血肿量多少选择是否保守或手术。手术治疗是可靠的方法，但由于手术前无脑血管造影，术后致残率较高。

Analysis of cerebral arteriovenous malformation correlated with intracerebral hemorrhage

Objective To discuss the diagnosis and treatment of AVM bleeding without DSA in the basic hospital.Methods Clinical difference of intracerebral hemorrhage was revienly analyzed between arteriovenous malformation and hypertensive intracerebral hemorrhage.Results Boths were different at sick ages,position and shape of haematoma,change of blood pressure after bleeding,CT scan of preoperative and view in operative.Surgery was effective.Conclusion Initial diagnosised of AVM bleeding is affirmed,according to patient's age,using mannitol is effective to control blood pressure after bleeding and display of CT scans preoperative.Final diagnosis is confirmed in operation without DSA at basic hospital.Treatment of AVM bleeding with surgery is effective.