年輕女性雙側基底核出血：病例報告

Bilateral Putaminal Hemorrhage in a Young Female: A Case Report

張凱閔(Ke-Vin Chang) ； 陳文翔(Wen-Shiang Chen) ； 梁蕙雯(Huey-Wen Liang)

《台灣復健醫學雜誌》 35卷4期 (2007/12) Pp. 235-240

https://doi.org/10.6315/2007.35(4)07

摘要

年輕患者的自發性腦出血，常見的原因爲異常血管構造、高血壓、使用抗凝劑與腦瘤等，而台灣地區則以高血壓居多。同時或極短時間內再發的多發性腦出血並不常有，對稱性的分布更爲罕見，過去的文獻以老年患者居多。本病例爲29歲女性，因急性右側肢體無力送至急診處，腦部電腦斷層呈現左側基底核出血，24小時內追蹤腦部磁振攝影，於右側基底核亦發現血腫，由於個案過去有血壓偏高的病史，影像與血液檢查亦未發現其他自發性腦出血的原因，故診斷爲高血壓性腦出血。本文呈現此病例之特殊表現，並回顧流行病學文獻，探討年輕病患腦出血的成因，以供臨床醫師參考。

關鍵字

基底核 ； 腦出血 ； 年輕型中風

並列摘要

Background: The etiology of spontaneous intracerebral hemorrhage (ICH) in young adults may include causative factors such as vascular abnormality, hypertension, anticoagulant therapy, brain tumor, and others. Hypertension is the most common cause of ICH in young adults in Taiwan. Simultaneous or multiple intracerebral hemorrhages are uncommon, and symmetrical distribution is even rarer. Most cases reported in the literature are in the elderly.
Case: We report the case of a 29 years old female with a history of hypertension and elevated blood pressure, who presented with an acute onset of right side limb weakness.
Results: Brain computed tomography (CT) showed hemorrhage in the left basal ganglia. Another small hematoma was detected in the right basal ganglia with brain magnetic resonance imaging (MRI) performed within 24 hours. The laboratory examination, including thyroid function, adrenal function, coagulation profile and immunological factors, did not reveal other possible causes of spontaneous ICH.
Conclusions: Hypertensive ICH was diagnosed because brain images and laboratory examination did not reveal other possible causes of spontaneous ICH. The clinical characteristics of the care are presented, and the epidemiology and etiology of ICH in young adults are discussed.

並列關鍵字

basal ganglia ； intracerebral hemorrhage ； young stroke