自发性脑叶出血73例病因分析

报告73例经CT证实的自发性脑叶出血,均行DSA检查,确定病因者61例(84％)。包括25例AVM,5例隐匿性血管畸形(经手术病理证实),28例动脉瘤,烟雾病、高血压和肿瘤各1例,其余12例原因未明。在30例脑血管畸形中,年龄40岁以下者29例,说明年青人脑叶出血的主要病因是AVM。28例动脉瘤中,前交通动脉瘤破裂的发生率最高,为16例(57％),且均造成额叶血肿,年龄50岁以上者13例,提示对年长者的额叶血肿,应注意前交通动脉瘤破裂的可能性。54例经手术治疗去除出血病因获痊愈。

Analysis of etiology of 73 cases with spontaneous lobar bitracerebral hemorrhage.

All of the 73 cases with spontaneous lobar in-tracerebral hemorrhage certified by CT scan were underwent DSA study. The etiology of 61 cases (84%) was determined, including 25 arteriove-nous malformation(AVM) ,5 cryptic cerebrovaiscu-lar malformations (determined by operation and pathology), 28 ruptured aneurysm, 1 moyamoya, 1 hypertension and one tumor. The etiologies of the remaining 12 cases were undetermined. 29 of 30 cases with cerebral vascular malformations were under 40 years of age. It was suggested that AVM is the main etiology of lobar intracerebral hemorrhage in young patients. Among the ruptured a-neurysms in 16(57%) of 28 cases,the lesions located in the anterior communicating arteria where is the site with highest rate of rupture. We found that anterior communicating arteria ruptured a-neurysm produced frontal lobar hematoma. 13 cases were over 50 years old, indicating that thefrontal lobar hematoma in older patients would exist the possibility of rupture of anterior communicating arteria aneurysm. 54 patients cured after the causes of bleeding were eliminated by operation.