中国典型病例大全

目的 探讨颅内隐匿性海绵状血管瘤（intracranial cavernous hemangioma,ICH）并发慢性扩展性脑内血肿的临床特点及诊断方法。方法 通过回顾性分析老河口市第一医院接诊的1例颅内隐匿性海绵状血管瘤并发慢性扩展性脑内血肿的病例，结合文献复习，探讨其发病机制、临床表现、辅助检查和治疗方法。结果 颅内海绵状血管瘤（intracranial cavernous angioma,ICA）是一种发病率仅次于动-静脉畸形的先天性脑血管畸形，术前诊断主要依赖于颅脑CT血管成像（computed tomography angiography,CTA）、磁共振成像技术（magnetic resonance imaging,MRI）和数字减影血管造影技术（digital subtraction angiography,DSA）。随着MRI的发展，其已成为诊断ICA的主要手段。然而，本病例在术前多次进行颅脑CTA、MRI和DSA检查均未能明确诊断，直至术后病检才确诊。该病例的诊疗过程对临床诊断和治疗提出了挑战。结论 颅内隐匿性海绵状血管瘤并发慢性扩展性脑内血肿的诊断具有一定难度，需要综合运用多种检查手段，并重视术后病检的作用。本病例的报道旨在提高临床医生对此类疾病的认识，避免延误治疗时机。

Objective To explore the clinical characteristics and diagnostic methods of the intracranial hidden cavernous hemangioma(ICH)complicated with chronic extended intracerebral hematoma. Methods In a case of hidden intracranial cavernous hemangioma complicated with chronic extended cerebral hematoma in Laohekou First Hospital, the pathogenesis, clinical manifestations, auxiliary examination and treatment methods were investigated through literature review. Results Intracranial cavernous angioma( ICH) is a congenital cerebrovascular malformation second only to arteriovenous malformation. Preoperative diagnosis mainly relies on the brain computed tomography angiography(CTA), magnetic resonance imaging technology(MRI), and digital subtraction angiography(DSA)techniques. With the development of MRI, it has become the main means of diagnosing ICH. However, in this case, multiple preoperative craniocerebral CTA, MRI and DSA examinations failed to confirm the diagnosis until the postoperative disease examination. The diagnosis and treatment process in this case poses challenges to clinical diagnosis and treatment. Conclusion The diagnosis of chronic extended intracranial hematoma is difficult, and it is attention to the function of postoperative disease examination. The report of this case aims to increase clinicians awareness of such diseases and avoid delayed treatment timing.