动脉瘤性蛛网膜下腔出血伴脑内血肿  

Aneurysmal subarachnoid hemorrhage secondary to intralcerebral hemotoma

作　　者：牛平[1] 陈欢意[1] 王耀山[1] 徐惠芹[1] 邵艳波[1] 何祥[1] 

机构地区：[1]沈阳军区总医院神经内科,辽宁沈阳110016

出　　处：《中风与神经疾病杂志》2005年第2期158-159,共2页Journal of Apoplexy and Nervous Diseases

摘　　要：目的　研究动脉瘤性蛛网膜下腔出血(a SAH)伴脑内血肿病例的临床特点。方法　对14例a SAH首次头部CT所见以明显的脑内血肿,伴发不同程度的蛛网膜下腔积血患者的临床表现、神经影像学、并发症及预后等资料进行分析。结果　本组患者表现头痛12例(85 .7% ) ,呕吐8例(5 7.1% ) ,一过性意识障碍2例(14 .3% ) ,昏迷6例(42 .9% ) ,抽搐2例(14 .3% ) ,脑膜刺激征阳性11例(78.6 % ) ,表现局灶神经功能障碍10例(71.4 % )。所有病例均经全脑血管造影检查(DSA)、或/和手术、尸解证实颅内动脉瘤。12例于神经外科手术后出院。2例死于脑疝。结论　a SAH伴脑内血肿病例一般病情较重,意识障碍及神经系统局灶定位体征的发生率高。这与额、颞叶脑实质受损,功能障碍相关。早期头部CT扫描主要表现为半球间裂、脑岛池部位的蛛网膜下腔积血,伴发明显的额、颞叶血肿。一经DSA明确动脉瘤,只要病情许可,最佳处理是尽快外科治疗。Objective To study the clinical features of cases suffering from aneurysmal subarachnoid hemorrhage secondary to intralcerebral hemotoma.Methods We studied the clinical manifestation,CT DSA findings,compliations and progrosis of 14 cases.Results In our study,12(85.7%)cases had headache,8(57.1%)cases vomiting,6(42.9%)cases coma,2(14.3%)cases seizure,11(78.6%)cases meningeal irritation.10(71.4%)cases local neurological impairmemt.All cases were examined by DSA、or operation and pathology.12 cases recoverd after surgery.2 cases died from hernia.Conclusion The clinical manifestions of cases suffering from aneurysmal subarachnoid hemorrhage secondary to intralcerebral hemotoma are very severe.Cerebral surgery must be done.

关 键 词：动脉瘤性蛛网膜下腔出血 脑内血肿 蛛网膜下腔积血 一过性意识障碍 脑血管造影检查 神经功能障碍 头部CT扫描 神经影像学 脑膜刺激征 颅内动脉瘤 外科手术后 临床特点 临床表现 不同程度 患者表现 定位体征 神经系统 主要表现 

分 类 号：R743.35[医药卫生—神经病学与精神病学] R651.15[医药卫生—临床医学]