Liu Junfeng, Wang Deren, Lei Chunyan, Xiong Yao, Yuan Ruozhen, Hao Zilong, Tao Wendan, Liu Ming
Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.
Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.
J Neurol Sci. 2015 Nov 15;358(1-2):367-70. doi: 10.1016/j.jns.2015.09.366. Epub 2015 Sep 28.
Much is known about spontaneous intracerebral hemorrhage (SICH) in adults, but few studies have examined pediatric SICH, especially in China. The aim of the present study was to describe the etiology, clinical characteristics and prognosis of SICH in children from southwest China.
Consecutive patients aged 1-18 years with SICH at our medical center were prospectively enrolled from January 2012 to June 2014. SICH was defined by WHO criteria and confirmed by CT or MRI findings. Demographic and clinical information was collected at baseline, and follow-up assessments were conducted at 3 and 6 months after SICH, when patients were scored on the modified Rankin Scale (mRS) and events of deaths and recurrent hemorrhagic stroke were recorded.
Among the 70 children (43 males; median age, 12.0 years) in the final analysis, 44 patients (62.9%) had SICH due to arteriovenous malformation, and less frequent etiologies were cavernous malformation (n=4), aneurysm (n=2), tumors (n=2), moyamoya (n=2), hemophilia (n=1), hypertension (n=1), while 14 (20.0%) had SICH of unknown etiology. The mortality rate at 3 months and 6 months was equal, which was both 3%. The rate of disability was 12.1% at 3 months and 9.1% at 6 months.
The most frequent etiology of pediatric SICH in this Chinese cohort was arteriovenous malformation. SICH of unknown etiology occurred much more often in our cohort than in previously published Caucasian patients in the US and Europe.
关于成人自发性脑出血（SICH）已有很多了解，但针对儿童SICH的研究较少，尤其是在中国。本研究旨在描述中国西南部儿童SICH的病因、临床特征及预后。
2012年1月至2014年6月，前瞻性纳入我院医学中心1 - 18岁连续的SICH患者。SICH根据世界卫生组织标准定义，并经CT或MRI检查结果证实。在基线时收集人口统计学和临床信息，并在SICH后3个月和6个月进行随访评估，此时对患者进行改良Rankin量表（mRS）评分，并记录死亡和复发性出血性卒中事件。
在最终分析的70名儿童（43名男性；中位年龄12.0岁）中，44例患者（62.9%）因动静脉畸形导致SICH，较少见的病因包括海绵状畸形（n = 4）、动脉瘤（n = 2）、肿瘤（n = 2）、烟雾病（n = 2）、血友病（n = 1）、高血压（n = 1），而14例（20.0%）病因不明。3个月和6个月时的死亡率相同，均为3%。3个月时的致残率为12.1%，6个月时为9.1%。
该中国队列中儿童SICH最常见的病因是动静脉畸形。与美国和欧洲先前发表的白种人患者相比，本队列中病因不明的SICH更为常见。
