青年自发性脑出血的病因及诊治

目的 探讨青年人自发性脑出血的病因及诊断治疗特点。方法分析42例自发性脑出血青年患者(年龄在45岁以下)的临床资料，其均急诊行CT检查，根据病情采取不同的治疗方法，其中手术治疗24例，血管内介入治疗5例，保守治疗13例。结果病因中AVM最常见．其次高血压，部分病因未明。AVM引起的青年自发性脑出血有82．4％(14／17)位于脑叶，高血压性脑出血有66．7％(8／12)位于脑基底节，75％(9／12)的高血压性脑出血患者年龄在40-45岁之间。治愈27例，好转12例，死亡3例。结论青年自发性脑出血最常见的病因是。AVM，AVM所致的脑出血主要位于脑叶。高血压性脑出血主要位于脑基底节，其发病率与年龄有明显的相关性。只要诊断及时，治疗得当．青年自发性脑出血一般预后良好。

Causes and management of spontaneous intracerebral hemorrhage in young adults

Objective To investigate the causes, diagnosis and treatment of the spontaneous intracerebral hemorrhage (SICH) in young adults. Methods The clinical data were reviewed in 42 young patients (age<45 years) with SICH who underwent CT examinations and were treated in different ways according to pa tient's conditions: 24 with surgical operation, 5 with intravascular interventio n and 13 with traditional treatment. Results The main causes of SICH in yo ung adults were brain arteriovenous malformations(AVM), the second was hypertens ion, but some causes were unknown. AVM causes 82.4% in which the SICH located in lobar. Hypertension causes 66.7% cases whose hemorrhage occurred in the basal g anglia, and 75% of the patients with SICH related to hypertension ranged from 40 to 45 years old. 27 cases were cured, 12 cases improved, and the other 3 died. Conclusion SICH in young adults mainly happens in lobar and results from v ascular malformation. SICH reduced by hypertension mostly located in the basal g anglia. When patients aged more than 40 years, it would increase the probability of hypertension as the main cause of SICH. Generally, the outcome of these pati ents is good if diagnosed and treated in time.