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自发性原发性脑室内出血的病因。

Etiological factors of spontaneous primary intraventricular hemorrhage.

机构信息

Department of Neurosurgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Br J Neurosurg. 2020 Aug;34(4):423-426. doi: 10.1080/02688697.2020.1751067. Epub 2020 Apr 20.

Abstract

Spontaneous primary intraventricular hemorrhage (SPIVH) is a distinct subtype of nontraumatic intracerebral hemorrhage in the ventricular system without a recognizable parenchymal component. The purpose of this study was to analyze the etiological characteristics of SPIVH. We analyzed the records of 88 patients with SPIVH that had been evaluated and treated at our institute from January 2011 to May 2018. All the patients with IVH associated with trauma were excluded. All the patients underwent at least 1 vascular imaging examination. There were 52 (59.1%) males and 36 females, aged between 5 and 76, with an average age of 38.1 years. Fourteen (15.9%) patients were in pediatric age range. Out of the 88 patients, vascular lesions were found in 46 patients (52.3%), hypertension in 21 (23.9%), coagulopathy in 1 (1.1%), tumor in 1 (1.1%), and idiopathic causes in 19 (21.6%). Among patients with vascular lesions, AVMs (43.5%) were the most dominant form (20/46), followed by MMD (28.2%), aneurysms (23.9%), AVMs with aneurysm (2.2%) and dAVF (2.2%). Spontaneous primary intraventricular hemorrhage is rare in clinical practice, hypertension and arteriovenous malformation are the most common factor. The main etiological factors of hemorrhage are various in different age groups.

摘要

自发性原发性脑室内出血(SPIVH)是一种无明显实质成分的脑室系统非外伤性脑内出血的独特亚型。本研究旨在分析 SPIVH 的病因特征。我们分析了 2011 年 1 月至 2018 年 5 月在我院评估和治疗的 88 例 SPIVH 患者的记录。所有与创伤相关的 IVH 患者均被排除。所有患者均至少进行了 1 次血管成像检查。男性 52 例(59.1%),女性 36 例,年龄 5-76 岁,平均 38.1 岁。14 例(15.9%)患者为儿科年龄组。在 88 例患者中,46 例(52.3%)发现血管病变,21 例(23.9%)高血压,1 例(1.1%)凝血障碍,1 例(1.1%)肿瘤,19 例(21.6%)原因不明。在有血管病变的患者中,AVM(43.5%)是最主要的形式(20/46),其次是 MMD(28.2%)、动脉瘤(23.9%)、AVM 伴动脉瘤(2.2%)和 dAVF(2.2%)。自发性原发性脑室内出血在临床上较为少见,高血压和动静脉畸形是最常见的病因。不同年龄组的出血主要病因各不相同。

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