Reith W
Neuroradiologie, Klinikum der RWTH Aachen.
Radiologe. 1999 Oct;39(10):828-37. doi: 10.1007/s001170050719.
Intracerebral hemorrhage is a common cause of acute neurological deterioration and a frequent indication for emergency neuroimaging. Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. It is often not possible to differentiate intracerebral hemorrhage from cerebral ischemia by clinical examination. The therapeutic decision between thrombolysis or conservative therapy is comprised by the etiology. To exclude intracerebral hemorrhage as the cause of clinical symptoms, a CT is usually performed. Localisation and extension of the acute intracerebral hemorrhage are easy to detect. Subacute and chronic intracerebral hemorrhage are better delineated with magnetic resonance imaging. The different signal of the hemorrhage can be used for the age of the intracerebral hemorrhage. The cause of a non-traumatic intracerebral hemorrhage is in over 60% hypertony, less frequent alcoholism, malformation, or amyloid angiopathy. Uncommon causes of hemorrhage are head trauma, blood dyscrasia, tumor or venous thrombosis. Non-traumatic intracerebral hemorrhage are most common in patients between 50 and 70 years. In younger patients a malformation should be excluded with a cerebral angiography. Intracerebral hemorrhages are usually conservatively treated, in some cases an operative decompression is performed.
脑出血是急性神经功能恶化的常见原因，也是紧急神经影像学检查的常见指征。10%至15%的中风症状由脑出血引起。通过临床检查往往无法区分脑出血和脑缺血。溶栓治疗或保守治疗的治疗决策取决于病因。为排除脑出血是临床症状的原因，通常会进行CT检查。急性脑出血的定位和范围很容易检测到。亚急性和慢性脑出血用磁共振成像能更好地显示。出血的不同信号可用于判断脑出血的时间。非创伤性脑出血超过60%的病因是高血压，较少见的病因是酗酒、畸形或淀粉样血管病。出血的罕见病因是头部外伤、血液系统疾病、肿瘤或静脉血栓形成。非创伤性脑出血在50至70岁的患者中最为常见。对于年轻患者，应通过脑血管造影排除畸形。脑出血通常采用保守治疗，在某些情况下进行手术减压。
