目的探讨高血压性脑出血(ICH)患者局部脑血流(rCBF)变化的意义。方法对60例ICH患者和31例对照者行脑血流单光子发射断层扫描(SPECT)显像,判定rCBF改变的部位及范围,并结合临床表现进行分析。结果ICH远离出血灶的同侧、对侧大脑半球和对侧小脑半球缺血发生率分别为70.0%、35.0%、和50.0%。基底节出血最常引起皮层失联络的部位是额叶(81.5%),其次是颞叶(68%)、顶叶(60.5%)、对侧小脑(48.5%)和枕叶(28%)。肢瘫越重者发生对侧小脑失联络现象越高。结论脑出血可引起远离出血灶的大脑半球及对侧小脑半球缺血。随着病情改善,rCBF也有所恢复。 Objective To investigate the significance of regional cerebral blood flow (rCBF) in patients with hypertensive intracerebral hemorrhage (ICH). Methods Cerebral blood flow single photon emission computed tomography (SPECT) imaging was performed on 60 ICH patients and 31 controls to determine the location and extent of rCBF changes and to analyze the clinical manifestations. Results The incidence of ischemic ICH on the ipsilateral, contralateral and contralateral hemispheres were 70.0%, 35.0%, and 50.0% respectively. The most common sites of hemorrhage in the basal ganglia were the frontal lobe (81.5%), followed by temporal lobe (68%), parietal lobe (60.5%), contralateral cerebellum (48.5%), and occipital lobe (28%). The more severe limb paralysis occurs contralateral cerebellar high contact loss phenomenon. Conclusion Intracerebral hemorrhage can cause ischemia in the hemispheres and the contralateral cerebellum far away from the hemorrhagic foci. As the condition improved, rCBF also recovered.