儿童自发性颅内出血104例回顾性分析
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摘要
目的:探讨儿童自发性颅内出血的临床表现、病因和治疗。方法:回顾性分析2010年1月至2017年12月收治104例儿童期(≤14岁)自发性颅内出血的临床资料,阐明其特点。结果:儿童期自发性颅内出血以头痛起病多见(81/104 77.9%),并绝大多数以头痛为主要临床表现(59/104 56.7%),部分头痛患儿合并面部、肢体瘫痪(20/59 33.9%),合并恶心和或呕吐(23/59 39.0%),合并偏盲言语障碍少见。其中脑血管疾病为主要发病因素,脑动静脉畸形(AVM)占70.2%。结论:儿童头痛病因很多,突发性、不典型的、严重的头痛患儿,不排除自发性颅内出血可能,需进一步检查,通过早期及时的诊断、合理的治疗方案,可显著提高疾病的治愈率。
Objective: To investigate the clinical manifestation,etiology and treatment of spontaneous intracranial hemorrhage in children. Methods: The clinical data of 104 cases of spontaneous intracranial hemorrhage in children from Jan. 2010 to Dec. 2017( ≤14 years old) were analyzed retrospectively,especially the findings of cerebral angiography,and their characteristics were elucidated. Results: The incidence of spontaneous intracranial hemorrhage in childhood with headache is more common( 81/104 77. 9%),and headache is the main clinical manifestation( 59/104 56.7%). Some of the children with headache are complicated with facial and limb paralysis( 20/59 33. 9%),combined nausea and vomiting( 23/59 39. 0%),but combined hemiinas and speech disorders are rare. Cerebrovascular disease is the main reason,and cerebral arteriovenous malformation( AVM) accounts for 70. 2%. Conclusion: There are many causes of headache in children. Sudden,atypical and severe headache children are likely spontaneous intracranial hemorrhage,and need further examination. Through early and timely diagnosis and reasonable treatment,the cure rate of the disease can be significantly improved.
Objective: To investigate the clinical manifestation,etiology and treatment of spontaneous intracranial hemorrhage in children. Methods: The clinical data of 104 cases of spontaneous intracranial hemorrhage in children from Jan. 2010 to Dec. 2017( ≤14 years old) were analyzed retrospectively,especially the findings of cerebral angiography,and their characteristics were elucidated. Results: The incidence of spontaneous intracranial hemorrhage in childhood with headache is more common( 81/104 77. 9%),and headache is the main clinical manifestation( 59/104 56.7%). Some of the children with headache are complicated with facial and limb paralysis( 20/59 33. 9%),combined nausea and vomiting( 23/59 39. 0%),but combined hemiinas and speech disorders are rare. Cerebrovascular disease is the main reason,and cerebral arteriovenous malformation( AVM) accounts for 70. 2%. Conclusion: There are many causes of headache in children. Sudden,atypical and severe headache children are likely spontaneous intracranial hemorrhage,and need further examination. Through early and timely diagnosis and reasonable treatment,the cure rate of the disease can be significantly improved.
引文
[1]孟艳举,宋来君,郭付有,等.儿童自发性脑出血病因及临床特点分析[J].中国现代神经疾病杂志,2014(1):47~50.
[2]Agesen FN,Risgaard B,Zachariasardottir S,et al.Sudden unexpected death caused by stroke:A nationwide study among children and young adults in Denmark.[J].Int Stroke,2017,13(3):174749301772462.
[3]王丽杰,孙莹,颜卫源.晚发性维生素K缺乏致颅内出血患儿的临床特征分析[J].中国医科大学学报,2014,43(10):946~949.
[4]祁伯祥,胡宝莉,盛利平,等.微创治疗在婴儿晚发维生素K缺乏致颅内出血中的应用价值[J].中国实用神经疾病杂志,2016,19(7):31~32.
[5]Murayama Y,Irie K,Saguchi T,et al.Robotic digital subtraction angiography systems within the hybrid operating room[J].Neurosurgery,2011,68(5):1427.
[6]冯文峰,王刚,张国忠,等.复合手术在颅内复杂血管疾病治疗中的应用[J].中华神经外科杂志,2016,32(7):701~705.
[2]Agesen FN,Risgaard B,Zachariasardottir S,et al.Sudden unexpected death caused by stroke:A nationwide study among children and young adults in Denmark.[J].Int Stroke,2017,13(3):174749301772462.
[3]王丽杰,孙莹,颜卫源.晚发性维生素K缺乏致颅内出血患儿的临床特征分析[J].中国医科大学学报,2014,43(10):946~949.
[4]祁伯祥,胡宝莉,盛利平,等.微创治疗在婴儿晚发维生素K缺乏致颅内出血中的应用价值[J].中国实用神经疾病杂志,2016,19(7):31~32.
[5]Murayama Y,Irie K,Saguchi T,et al.Robotic digital subtraction angiography systems within the hybrid operating room[J].Neurosurgery,2011,68(5):1427.
[6]冯文峰,王刚,张国忠,等.复合手术在颅内复杂血管疾病治疗中的应用[J].中华神经外科杂志,2016,32(7):701~705.