Objective：To investigate the etiology and clinical features of children with spontaneous intracranial hemorrhage（SIH）. Methods：A total of 213 children with SIH who were admitted to our hospital from January 2012 to December 2017 were enrolled，and their age，etiology，CT findings，and other clinical data were analyzed. Results：SIH mainly occurred in infancy（21.1%） and school age（41.3%），and main etiologies included vascular malformations（44.1%），hemorrhagic cerebral paragonimiasis（23.5%），and coagulation disorder（22.1%）. Hemorrhage due to coagulation disorder was the most common etiology in infancy，hemorrhagic cerebral paragoni-miasis was the most common etiology in pre-school age，and vascular malformations were the most common etiology in school age and adolescence. Hemorrhage due to coagulation disorder often occurred at multiple anatomical sites，hemorrhage due to vascular malfor-mations often occurred at a single anatomical site and was located in the brain parenchyma and the ventricle，and hemorrhage due to cerebral paragonimiasis was located in the superficial part of the frontal parietal occipital cortex. With the stabilization and absorption of the hematoma，ring-shaped high density with marked edema was observed around the lesion. Conclusion：SIH in children has a characteristic distribution in age and etiology，and hemorrhage due to different etiologies has its own imaging features. The cause of hemorrhage can be identified based on age and imaging findings，and active etiological treatment should be given at the same time to reduce the risk of rebleeding.
