以蛛网膜下腔出血为主要表现的儿童病例回顾性分析

摘要

目的 回顾性分析儿童蛛网膜下腔出血(subarachnoid hemorrhage,SAH)的病因、临床特点、影像学表现及治疗.方法 对2003年1月至2011年6月在北京天坛医院儿科就诊的18例SAH患者病历资料进行回顾性分析.结果 18例患者中,男10例,女8例.发病年龄1～18岁,平均年龄(11.33±5.20)岁.病因中外伤(走路时摔例或坠床)4例(22.2％),动静脉畸形3例(16.7％),动脉瘤2例(11.1％),高血压及低纤维蛋白原血症各1例,7例(38.9％)未找到明确病因.16例表现为头痛(88.9％),伴意识障碍者5例(27.8％),伴抽搐发作、失语或构音障碍、肌力下降者各4例.所有患者均经计算机断层扫描(computed tomography,CT)或磁共振成像(magnetic resonance imaging,MRI)证实SAH.结论 SAH可发生于儿童各个年龄段,头痛及意识障碍为最常见的临床表现.本研究中头部外伤和动静脉畸形是主要病因.%Objective To analyze the etiology.clinical features, imaging features and treatment of subarachnoidrnhemorrhage in children.rnMethods The clinical data of 18 children with subarachnoid hemorrhage who were hospitalized inrnBeijing Tiantan Hospital Affiliated to the Capital Medical University from Jan. 2003 to Jun. 2011rnwere analyzed retrospectively. Eighteen children were enrolled.rnResults There were 10 boys and 8 girls, median onset age was 11.33 years(ranged from 1 year torn18 years old). Etiology included mild trauma(22.2%), arteriovenous malformation of brain(16.7%),rnaneurysma(11.l%), hypertension(5.6%) and lower fibrinogen hematic disease(5.6%). 38.9rnpercent(n=7) had no identifiable cause. The most frequent clinical manifestation was headache(seenrnin 88.9% patients). Disturbance of consciousness was found in 5 cases. Other neurologicalrnmanifestation included convulsion, dysarthria and muscle strength down. All cases were confirmedrnby imaging examination.rnConclusion Subarachnoid hemorrhage can happen in any age. Headache and disturbance ofrnconsciousness are the most common neurological manifestations.