Yamasaki M, Akagi K, Niinomi K, Kinoshita S, Kitawaki T, Yoshioka K
No To Hattatsu. 1989 May;21(3):215-21.
Intracranial hemorrhage is a fatal complication associated with aplastic anemia. We have encountered four patients who experienced six episodes of intracranial hemorrhage (intracerebral hemorrhage; 3, subarachnoid hemorrhage; 2, and subdural hematoma; 1,). Intracranial hemorrhage occurred without traumatic episodes, and was followed by frequent hemorrhagic episodes in other parts of about one year duration. This disease is considered to recur after a short interval. The site, type and degree of intracranial hemorrhage varied, and therefore intracranial hemorrhage seemed to be caused not only by thrombocytopenia but also by multifactorial hemorrhagic tendency. Transfusion of platelet rich plasma, and administration of Glycerol and steroids produced good results for conservative therapy. Continuous spinal drainage for subarachnoid hemorrhage was a relatively safe and useful means of management. In the patients who showed precipitous deterioration, the CT scan findings indicated that the high-density-area was diffusely spread with an unclear border, just like "contusional hemorrhage". For such severe cases, blood evacuation with craniotomy and emergency splenectomy are considered to be valuable.
颅内出血是再生障碍性贫血的一种致命并发症。我们遇到了4例患者，共经历了6次颅内出血发作（脑出血3次、蛛网膜下腔出血2次、硬膜下血肿1次）。颅内出血发生时无外伤史，随后约一年时间内其他部位频繁出现出血发作。该病被认为会在短时间内复发。颅内出血的部位、类型和程度各不相同，因此颅内出血似乎不仅由血小板减少引起，还由多因素出血倾向导致。输注富含血小板的血浆以及给予甘油和类固醇进行保守治疗取得了良好效果。蛛网膜下腔出血采用持续脊髓引流是一种相对安全且有用的治疗方法。在病情急剧恶化的患者中，CT扫描结果显示高密度区域边界不清、广泛扩散，类似“挫伤性出血”。对于此类严重病例，开颅血肿清除术和急诊脾切除术被认为是有价值的。
