摘要
目的探讨并分析自发性蛛网膜下腔出血全脑血管造影阴性患者的临床特点。方法回顾性分析2003年8月—2011年11月河北医科大学第一医院神经外科收治的86例全脑血管造影阴性自发性蛛网膜下腔出血患者的临床资料,包括临床表现、实验室检查、治疗方法及复查情况。结果 (1)临床表现:86例患者均有不同程度头痛,73例出现脑膜刺激征,62例出现恶心和(或)呕吐,37例伴有高血压史。(2)实验室检查:86例患者CT扫描未发现单纯脑室内出血或单纯脑实质内出血,伴有脑室内出血4例,硬膜下血肿3例,纵裂血肿2例。有74例再次行全脑血管造影,发现颅内动脉瘤22例,其中14例伴高血压,术前脑血管造影显示颅底大动脉或主干动脉血管壁不光滑。(3)治疗方法及复查结果:22例动脉瘤患者中8例保守治疗,7例行颅内动脉瘤栓塞术,4行颅内动脉瘤夹闭术,3例行载瘤动脉支架置入;复查均未见异常。结论全脑血管造影阴性自发性蛛网膜下腔出血患者有颅内动脉瘤或其他病变的可能,必要时应复查造影。
Objective To study the clinical characteristics of patients with spontaneous subarachnoid hemorrhage and cerebral negative angiographic results. Methods Clinical data, including clinical manifestations, laboratory tests, treatments and reexaminations of 86 patients with spontaneous subarachnoid hemorrhage and cerebral negative angiography admitted to the First Hospital of Hebei Medical University from August 2003 to November 2011 were retrospectively analyzed. Results （ 1 ） Clinical manifestations ： 86 patients all had different degrees of headache, 73 cases had meningeal irritation, 62 cases had nau- sea and （or） vomit and 37 cases had hypertension history. （2） Laboratory tests： CT scan showed no simple intraventricular hemorrhage or parenchymal hemorrhage, 4 cases had combined intraventricular hemorrhage, 3 cases had subdural hematoma and 2 cases had Interhemispheric subdural hematomas. 74 cases were once again given cerebral angiography, showing intracranial an- eurysm in 22 cases and combined hypertension in 14 cases. The preoperative DSA showed that the vascular wall of skull base ar- tery or trunk artery was not smooth. （3） Treatment and reexamination： among the 22 cases of arterial aneurysm, 8 cases were given conservative treatment, 7 cases were given intracranial aneurysm surgery and 3 cases were given parent artery stenting. No abnormalities were found in reexamination. Conclusion Spontaneous subarachnoid hemorrhage with cerebral negative angio- graphic results may have intracranial aneurysm or other lesions and reexamination of angiography should be conducted when neces- sary.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第5期535-536,共2页
Chinese General Practice
关键词
蛛网膜下腔出血
脑血管造影术
阴性
Subarachnoid hemorrhage
Cerebral angiography
Negative
