270例动脉瘤性蛛网膜下腔出血积血部位与动脉瘤部位相关性分析  

Correlation between location of hematoma and aneurism in aneurismal subarachnoid hemorrhage:report of two hundred and seventy cases

作　　者：张萍[1] 潘邓记[1] 田代实[1] 李倩[1] 梅翠红[1] 陈黛琪[1] 骆翔[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《卒中与神经疾病》2012年第1期8-11,共4页Stroke and Nervous Diseases

基　　金：国家青年自然科学基金(81000521)

摘　　要：目的研究动脉瘤性蛛网膜下腔出血的积血部位与动脉瘤部位之间的相关性。方法回顾性分析270例动脉瘤性蛛网膜下腔出血患者的影像学资料,以了解积血部位与动脉瘤部位之间的相关性。结果 270例患者中前交通动脉瘤86例,大脑前动脉瘤19例,头颅CT均显示前纵裂积血;脉络膜前动脉瘤40例,后交通动脉瘤82例,多数在CT上显示广泛鞍上池积血,病变同侧积血多于对侧;大脑中动脉瘤32例,CT多显示病变同侧外侧裂积血;后循环动脉瘤11例,头颅CT多见鞍上池及脑室系统积血;出血量较大时,除具备上述特征外,积血部位更广泛,特异性相对较小。结论动脉瘤性蛛网膜下腔出血的积血部位与动脉瘤部位存在一定的对应关系,根据头颅CT所示积血部位可初步判断动脉瘤的部位,对数字减影血管造影时血管检查顺序的选择及治疗方法的预估有重要价值。Objective To analyze the correlation between the location of hematoma and aneurysm in aneurismal subarachnoid hemorrhage. Methods 270 patients who were diagnosed with aneurismal subarachnoid hemorrhage were investigated.The relationship between the location of hematoma and aneurysm was analyzed. Results All of the 86 cases with anterior communicating artery aneurysm and the 19 cases with anterior cerebral artery aneurysm had hematomas in anterior longitudinal division in CT.Most of the 40 cases with anterior choroidal artery aneurysm and the 82 cases with posterior communicating artery aneurysm had hematomas in suprasellar cistern in CT.Most of the 32 cases with middle cerebral artery aneurysm had hematomas in homonymy lateral fissure in CT.Hematomas in suprasellar cistern and ventricular system were found in most of the 11 cases with vertebrobasilar system aneurysm.Hematomas were not characteristic in the cases of massive hemorrhage. Conclusions According to the correlation between the location of hematoma and aneurysm in aneurismal subarachnoid hemorrhage,the location of aneurysm can be initially presumed on the basis of head CT scan.It is valuable for the determination of detection sequence in digital subtraction angiography and surgical treatment.

关 键 词：蛛网膜下腔出血 动脉瘤 数字减影血管造影 

分 类 号：R743.35[医药卫生—神经病学与精神病学]