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足月儿和幼儿颅内出血:出血部位与预后的相关性

Intracranial hemorrhage in the full-term neonate and young infant: correlation of the location and outcome.

作者信息

Nanba E, Eda I, Takashima S, Ohta S, Ohtani K, Takeshita K

出版信息

Brain Dev. 1984;6(5):435-43. doi: 10.1016/s0387-7604(84)80025-x.

Abstract

The cranial computed tomography (CT) and outcome for 13 full-term neonates and 12 young infants with intracranial hemorrhage (ICH) were studied. The full-term neonates had perinatal asphyxia or neurological signs such as seizures. All infants were breast-fed and showed bleeding diathesis. In the full-term neonates there was a high incidence of intraventricular hemorrhage (IVH) and hemorrhage around the falx. The location of the hemorrhage on CT and brain pathology suggested that the original site of IVH might be the choroid plexus vessels in the lateral ventricle or in the subependymal layer. On the other hand, the sites of ICH in infants were multifocal compared with those in full-term neonates. Subdural hemorrhage (SDH) was seen more frequently and IVH less frequently in infants than in full-term neonates. The cases with SDH frequently showed accompanying cerebral infarction followed by porencephaly. Thus, SDH with cerebral low density on CT may predict a poor prognosis.

摘要

对13例足月新生儿和12例颅内出血(ICH)的幼儿进行了头颅计算机断层扫描(CT)及预后研究。足月新生儿有围产期窒息或惊厥等神经症状。所有婴儿均母乳喂养且有出血倾向。足月新生儿脑室内出血(IVH)及大脑镰周围出血发生率较高。CT上出血部位及脑病理学检查提示IVH的原始部位可能是侧脑室脉络丛血管或室管膜下层。另一方面,与足月新生儿相比,幼儿ICH部位多为多灶性。幼儿硬膜下出血(SDH)较足月新生儿更常见,而IVH则较少见。SDH病例常伴有脑梗死,继之出现孔洞脑。因此,CT上表现为低密度的SDH可能预示预后不良。

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