慢性包裹性脑内血肿：发病机制与诊断考量

Fiumara E, Gambacorta M, D'Angelo V, Ferrara M, Corona C

Department of Neurosurgery, Niguarda Ca'Granda Hospital, Milan, Italy.

J Neurol Neurosurg Psychiatry. 1989 Nov;52(11):1296-9. doi: 10.1136/jnnp.52.11.1296.

Two cases of chronic encapsulated intracerebral haematoma are reported. The patients presented with progressive neurological deficits. Computed tomography scan showed a roundish, intracerebral lesion, that revealed ring blush after contrast infusion, with mass effect. At operation a thick, fibrous, brownish capsule, containing clots in different states of formation, was removed. The hypothesis of capsule formation due to an exuberant proliferation of arachnoidal fibroblasts, is discussed. Differentiation between encapsulated intracerebral haematoma and other chronic intracerebral blood collections is considered mandatory for appropriate treatment.

报告了两例慢性包裹性脑内血肿。患者表现为进行性神经功能缺损。计算机断层扫描显示一个圆形脑内病变，注入造影剂后显示环形强化，并伴有占位效应。手术中切除了一个厚的、纤维性的、褐色的包膜，包膜内含有处于不同形成阶段的血凝块。讨论了蛛网膜成纤维细胞过度增殖导致包膜形成的假说。为了进行适当的治疗，区分包裹性脑内血肿和其他慢性脑内血肿是必不可少的。