Veira C, Castro-Vilanova D, Ferreiro A, Sánchez-Suárez C, Cuadrado M L, Simón R, Mateos F
Unidad de Neuropediatría, Hospital Doce de Octubre, Madrid, España.
Rev Neurol. 1997 Sep;25(145):1381-2.
Spontaneous or non-traumatic intracranial haemorrhages seen in children of under 15 years old are most frequently due to cerebral vascular malformations, followed at a considerable distance by blood disorders, vasculopathies, tumours and the complications of radio-therapy.
To present the cases of spontaneous and non-traumatic cerebral haemorrhage seen at our hospital.
We reviewed all the paediatric cases of spontaneous cerebral haemorrhage diagnosed in our hospital over the previous sixteen years, excluding bleeding in the neonatal period. Computerized tomography was done in all cases, study of the cerebrospinal fluid, angiography and/or magnetic resonance in some cases.
We selected 44 patients, of who the aetiology could be determined in 30. Of these, 20 cases were due to vascular malformations, 7 were associated with haematological disorders, 2 with cerebral tumours and one case with meningococcal sepsis. The commonest form of presentation was that of an acute intracranial hypertension syndrome, also showing focal deficits, partial crises and meningism.
The commonest cause of spontaneous intracranial haemorrhage in children is due to rupture of a vascular malformation, namely an arterio-venous malformation. Angiography and/or magnetic resonance are the techniques of choice for diagnosis. The various causes of disorders of haemostasia also are important in giving rise to intracranial bleeding.
15岁以下儿童出现的自发性或非创伤性颅内出血最常见的原因是脑血管畸形，其次是血液疾病、血管病变、肿瘤以及放射治疗并发症，但差距较大。
介绍我院收治的自发性和非创伤性脑出血病例。
我们回顾了我院过去16年诊断的所有小儿自发性脑出血病例，不包括新生儿期出血。所有病例均进行了计算机断层扫描，部分病例进行了脑脊液检查、血管造影和/或磁共振成像。
我们选取了44例患者，其中30例病因可明确。其中，20例因血管畸形，7例与血液系统疾病有关，2例与脑肿瘤有关，1例与脑膜炎球菌败血症有关。最常见的表现形式是急性颅内高压综合征，也表现为局灶性缺损、部分发作和脑膜刺激征。
儿童自发性颅内出血最常见的原因是血管畸形破裂，即动静脉畸形。血管造影和/或磁共振成像是诊断的首选技术。止血障碍的各种原因在引发颅内出血方面也很重要。
