Clinical Analysis Of 213 Children With Spontaneous Intracranial Hemorrhage

Objective:To investigate the etiology,clinical characteristics and outcome of spontaneous intracranial hemorrhage(SIH)in children.Methods:213 children with SIH admitted to our hospital from January2012 to December 2017 were collected,and their age,etiology,CT manifestations,outcome and other clinical data were analyzed.Results:The main age groups of spontaneous intracranial hemorrhage in children were infants(21.1%)and school-age children(41.3%).Vascular malformations(44.1%),hemorrhagic cerebral paragonimiasis(23.5%)and coagulation dysfunction(22.1%)are the top 3 causes of SIH.Coagulation dysfunction is the main cause in infants,and hemorrhagic cerebral paragonimiasis is the main cause in early school age,and vascular malformation is the first cause in school-age and adolescent children.CT manifestations vary from different cause.Hemorrhagic focus of coagulation dysfunction mostly locate in multiple anatomical sites while hemorrhagic focus of vascular malformations locate in single anatomical site especially in parenchyma and ventricle system.All the hemorrhages caused by hemorrhagic cerebral paragonimiasis were located in the superficial part of the frontal parietal occipital cortex.With the stabilization and absorption ofthe hematoma,there was ring density around the lesion,and the edema around the hemorrhage site was aggravated.There were statistically significant differences in the distribution of prognosis between GCS score,hemorrhage volume and surgical intervention(P<0.05),among which GCS score at admission was an independent risk factor for poor prognosis(P=0.015).Conclusion:Spontaneous intracranial hemorrhage in children has a characteristic distribution in age and etiology,and the imaging manifestations of different etiologies have their own characteristics.The GCS score can be assessed for the poor outcome,and the surgical procedure is an effective measure to ensure good prognosis.The causes of hemorrhage can be actively sought while the hemorrhage is treated,and the risk of re-hemorrhage can be reduced by appropriate treatment.