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KMID : 0376219930300010045
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Chonnam Medical Journal
1993 Volume.30 No. 1 p.45 ~ p.46
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CT and MRI Findings of Nontraumatic Lobar Intracerebral Hemorrhage Differential Diagnosis of Etiologic Diseases
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Abstract
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Nontraumatic lobar intracerebral hemorrhages occur in the subcortical white mat￢ter due to a wide variety of causes. But, the differential diagnosis of etiologic dis￢ease is difficult because of similarity of the radiologic findings.
The authors reviewed CT and MRI findings of 48 cases of nontraumatic lobar in￢tracerebral hemorrhages (22 cerebrovascular malformations, 10 systemic hypertension, 8 cerebral aneurysms, 5 brain tumors, and 3 blood dyscrasia) confirmed by histopathologic, radiologic, and clinical examinations from July 1989 to June 1993, and analyzed the age of patients, location, shape, size, surrounding edema, associated hemorrhage, and contrast enhancement pattern of the hemorrhages according to each etiology to find out the differential points.
The characteristics of the etiologic diseases are as follows.
1) Cerebral vascular malformations: under the age of 30, associated with IVH, serpiginous vascular structure on contrast enhancement.
2) Systemic hypertension: hemorrhages located at parietal, superior temporal and temporoparietal lobe, but not at frontal and inferior temporal lobe, associated with IVH but not with SAH.
3) Cerebral aneurysms: hemorrhages located at frontal and temporal lobes, associated with SAH and IVH.
4) Brain tumors: extensive surrounding edema, inhomogeneous contrast enhanced
portion near hemorrhage, and multiple location in metastatic tumors.
5) Vitamin K deficiency: under the age of 1, bizarre shape, associated with SAH. In conclusion, the age of patients and CT and MRI findings in nontraumatic lobar intracerebral hemorrhages make it possible to differentiate the various etiologic dis￢eases, and also may help to decide the treatment and the follow-up diagnostic studies.
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KEYWORD
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