CAJ | 학술논문

目的分析淀粉样脑血管相关性脑出血的临床特点、诊断及治疗方法.方法对4例病理确诊的淀粉样脑血管病相关性脑出血患者的临床表现、治疗、转归进行总结.结果 4例患者均表现为大量脑叶出血,均行开颅血肿清除术,术后再出血1例,术后联合重组活化凝血因子Ⅶ治疗2例.6个月内再次出血3例,再出血死亡1例.结论淀粉样脑血管病相关性脑出血临床表现多样,再出血风险高,确诊仍需病理.高龄患者仍可手术治疗,大量出血虽存在手术风险,但仍是挽救患者生命较好的方法.
목적 분석정분양뇌혈관상관성뇌출혈적림상특점、진단급치료방법.방법 대4례병리학진적정분양뇌혈관병상관성뇌출혈환자적림상표현、치료、전귀진행총결.결과 4례환자균표현위대량뇌협출혈,균행개로혈종청제술,술후재출혈1례,술후연합중조활화응혈인자Ⅶ치료2례.6개월내재차출혈3례,재출혈사망1례.결론 정분양뇌혈관병상관성뇌출혈림상표현다양,재출혈풍험고,학진잉수병리.고령환자잉가수술치료,대량출혈수존재수술풍험,단잉시만구환자생명교호적방법.
Objective To analyze the clinical manifestations,diagnosis and treatment of cerebral amyloid angiopathy (CAA) associated intracerebral hemorrhage.Methods The clinical manifestations,treatment and prognosis of CAA associated intracerebral hemorrhage were analyzed in 4 patients who were identified as CAA-related hemorrhage (CAAH) by pathology.Results All of the 4 patients showed massive lobar intracranial hemorrhage,and underwent craniotomy evacuation of hematoma.One patient had postoperative hemorrhage,and 2 patients were treated with recombinant activated factor Ⅶ after operation.In the next 6 months,re-hemorrhage was found in 3 patients in whom one patient died due to massive hemorrhage.Conclusions CAAH has varied clinical manifestations with high risk of cerebral hemorrhage,and pathological diagnosis is necessary for a definite diagnosis.The very elderly patients with CAAH can benefit from the craniotomy evacuation of hematoma.Although surgery for massive hemorrhage has risks in very elderly patients,it is a better treatment to save their lives.