Shimizu K, Miyazaki Y
Hokkaido Igaku Zasshi. 1975 Sep;50(5):467-75.
The hematomas occupied between the inner surface of skull and brain surface are well known and the majority of these intracranial hematomas are elicited by head injury. On the other hand, the intracerebral hematomas formed in the brain tissue are produced by the various causative diseases and the majority of these cause are cerebrovascular disease. The causative diseases of intracerebral hematomas were cerebrovascular diseases like hypertension, intracranial aneurysm and cerebral arteriovenous malformation in 65.7% and head injury in 32.4%. The cause of two cases were bleeding from asymptomatic brain tumors and formation of intracerebral hematoma produced initial clinical symptom of these cases. Age distribution of intracerebral hematoma has peculiarity in each causative disease. Hypertensive intracerebral hematomas occurred in patients over 30 years old and intracerebral hematoma due to bleeding from cerebral arteriovenous malformation was not observed in patient over 50 years old. The frequency of consciousness change as initial symptom of traumatic intracerebral hematome, hypertensive intracerebral hematome, intracerebral hematoma caused by bleeding from cerebral arteriovenous malformation and bleeding from intracranial aneurysm and spontane intracerebral hematome are 79.4%, 57.1%, 57.1%, 40.0% and 25.0% respectively. Headache as initial symptom are conspicuous in patients of intracerebral hematoma caused by bleeding from intracranial aneurysm and arteriovenous malformation, and each frequency were 86.7% and 71.4%. The frequency of motor disturbance as initial symptom was highest in patients of hypertensive intracerebral hematoma and its frequency was 50.0%. Clinical symptoms observed at admission were as follows: Consciousness change in patients of hypertensive intracerebral hematoma and traumatic intracerebral hematoma were 100% but in patients of cerebral arteriovenous malformation and intracranial aneurysm were 64.3% and 60.0%. Consciousness change in patients of spontane intracerebral hematoma were only 50.0%. Motor disturbance as clinical symptom were 85.0% in hypertensive intracerebral hematoma and this frequency was highest in all causative diseases. The frequency of coincidence between the side of dilated pupil under anisocoria and the side of hematoma was less than 50.0% in average and this frequency was marked lower by compared with the frequency in patients of hematome formed between the skull and brain surface.
颅骨内表面与脑表面之间的血肿是众所周知的,这些颅内血肿大多数由头部损伤引起。另一方面,脑实质内形成的脑内血肿由各种致病疾病导致,其中大多数病因是脑血管疾病。脑内血肿的致病疾病中,65.7%为高血压、颅内动脉瘤和脑动静脉畸形等脑血管疾病,32.4%为头部损伤。2例病因是无症状脑肿瘤出血,脑内血肿的形成是这些病例的初始临床症状。脑内血肿在每种致病疾病中的年龄分布都有其特殊性。高血压性脑内血肿发生在30岁以上的患者中,50岁以上的患者未观察到因脑动静脉畸形出血导致的脑内血肿。外伤性脑内血肿、高血压性脑内血肿、脑动静脉畸形出血导致的脑内血肿、颅内动脉瘤出血导致的脑内血肿和自发性脑内血肿以意识改变为初始症状的频率分别为79.4%、57.1%、57.1%、40.0%和25.0%。头痛作为颅内动脉瘤和动静脉畸形出血导致的脑内血肿患者的初始症状较为明显,频率分别为86.7%和71.4%。运动障碍作为初始症状在高血压性脑内血肿患者中频率最高,为50.0%。入院时观察到的临床症状如下:高血压性脑内血肿和外伤性脑内血肿患者的意识改变为100%,但脑动静脉畸形和颅内动脉瘤患者分别为64.3%和60.0%。自发性脑内血肿患者的意识改变仅为50.0%。运动障碍作为临床症状在高血压性脑内血肿中为85.0%,在所有致病疾病中该频率最高。瞳孔不等大时患侧瞳孔扩大与血肿侧的一致性频率平均低于50.0%,与颅骨和脑表面之间形成血肿的患者相比,该频率明显较低。