Kobayashi N, Itou T, Takahashi A, Yanagihara T
Hokkaido Igaku Zasshi. 1986 Nov;61(6):969-73.
Three cases of ongoing intracerebral hematoma are reported. In all cases, a very small hematoma on the initial CT taken within 2 hours after onset increased in size to such an extent that surgical intervention was necessary. A round radiolucent zone in high density clots was seen on the initial CT of all cases. The attenuation values of each pixels in hematoma formed V-figure in profile display, vfrying from minimum density (40-60) in the center of radiolucent zone to the maximum density (80-90) in peripheral clots. Experimental data have established that the density of blood in circulation and, therefore, one immediately after extravasation is directly related to the patient's hemoglobin and hematocrit levels. Hemoconcentration following clot formation and serum absorption in the brain tissue results in further increase of hematoma density. The radiolucent zone in a intracerebral hematoma suggests extravasated fresh blood. Therefore, we conclud that this is an evidence of active bleeding which calls for immediate surgery.
报告了3例进行性脑内血肿。在所有病例中，发病后2小时内进行的初次CT显示的非常小的血肿增大到需要手术干预的程度。所有病例的初次CT上均可见高密度血凝块内的圆形透亮区。血肿中每个像素的衰减值在轮廓显示中形成V形，从透亮区中心的最小密度（40-60）到周边血凝块的最大密度（80-90）。实验数据表明，循环血液的密度，因此也就是外渗后立即测得的密度，与患者的血红蛋白和血细胞比容水平直接相关。血凝块形成以及脑组织中血清吸收后的血液浓缩导致血肿密度进一步增加。脑内血肿中的透亮区提示新鲜血液外渗。因此，我们得出结论，这是活动性出血的证据，需要立即手术。
