Nakajima Y, Ohsuga H, Yamamoto M, Shinohara Y
Department of Neurology, Tokai University School of Medicine.
Rinsho Shinkeigaku. 1991 Mar;31(3):270-4.
Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history of known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 till June 1990, 2757 patients have undergone 3474 times of MR scan of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. 17 patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. Seventeen patients correspond to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage, which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhages were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhages were due to AVM and angiomas in the frontal cortex, thalamus and pons.
在无卒中病史患者的CT片上检测到既往脑梗死是常见现象。据报道，无症状脑梗死的发生率约为10%至11%，但关于无症状脑出血的报道却很少。然而，近年来MRI的临床应用使得在无已知卒中样发作病史的患者中检测到陈旧性无症状脑出血成为可能。本研究的目的是阐明接受MRI检查的患者中无症状脑出血的发生率、病因及特征。1987年9月至1990年6月，我院2757例患者使用1.0特斯拉西门子Magneton装置进行了3474次脑部MR扫描。17例患者未表现出与检测到的出血性病变相对应的卒中发作的临床体征或症状。17例患者占接受MRI检查患者的0.6%，占脑血管疾病患者的1.5%，占脑出血患者的9.5%，这一比例高于预期。在这17例患者中，12例被诊断为原发性脑出血，5例为继发性脑出血。大多数原发性无症状出血为高血压性出血，表现为壳核与屏状核或外囊之间的裂隙状曲线形病变。继发性无症状出血是由额叶皮质、丘脑和脑桥的动静脉畸形和血管瘤引起的。
