非高血压性自发性颅内出血病因及治疗研究

目的 分析非高血压性自发性颅内出血的病因,并对其治疗进行探讨.方法 对60例非高血压性自发性蛛网膜下腔出血(SAH)和42例脑实质内出血患者进行分析,均行DSA检查并采取相应治疗措施.结果 60例SAH的患者中,动脉瘤52例(86.67%),脑动静脉畸形(CAVM)1例(1.67%),动脉瘤合并CAVM 1例(1.67%),血液病1例(1.67%),造影阴性5例(83.33%);在42例脑实质出血(包括脑室出血)的患者中,动脉瘤15例(35.71%),CAVM 9例(21.43%),moyamoya病3例(7.14%),右侧椎动脉变细1例,海绵窦血栓性静脉炎1例,13例(30.95%)造影未发现异常.结论非高血压性SAH的主要原因为动脉瘤破裂,自发性脑实质出血的主要原因为动脉瘤和脑动静脉畸形破裂,临床DSA检查是确诊其病因的重要手段之一,自发性颅内出血病因的早期诊断和对因治疗具有重要临床意义.

Analysis of etiology and treatment of spontaneous intracerebral hemorrhage without hypertension

Objective To explore the cause,method for diagnosis and treatment of spontaneous intracerebral hemorrhage. Methods To analyse 60 cases of spontaneous subarachnoid hemorrhage and 42 cases of spontaneous cerebral hemorrhage and discuse their clinical feature. The cerebral DSA were performed in all cases. Results In 60 SAH cases,52 cases was checked aneurysm,1 arteriovenous malformation,1 aneurysm and arteriovenous,1 blood disease,5 cases DSA negative. 15 aneurysm,9 arteriovenous,3 moyamoya disease,13 DSA negative and 2 other diseases in 42 spontaneous cerebral hemorrhage cases. Conclusion Cerebral aneurysm are the most common causes of spontaneous subarachnoid hemorrhage,while the aneurysms,CAVM,moyamoya diseases are the main causes of the spontaneous intracerebral hemorrhage. Cerebral DSA is a reliable diagnosis approach for cerebral hemorrhage. The effect of endovascular neurosurgery is reliable. The early diagnosis of causes has important significance for treatment and clinic outcome.