中脑周围非动脉瘤性蛛网膜下腔出血的诊治分析  

Clinical analysis of treatment and diagnosis of perimesencephalic nonaneurysmal subarachnoid hemorrhage (report of 43 cases)

作　　者：申彦杰[1,2] 马廉亭[1] 杨铭[1] 李俊[1] 潘力[1] 陈刚[1] 成文平 肖炳祥[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070 [2]河南省安阳市第六人民医院神经外科

出　　处：《中国临床神经外科杂志》2014年第1期15-17,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的总结脑干前非动脉瘤性蛛网膜下腔出血（PMSAH）的临床特点及治疗效果。方法对我科2011年12月至2012年11月共收治的43例PMSAH患者的临床表现、影像学资料、诊断及治疗情况进行分析。结果首次全脑数字减影血管造影（DSA）检查阴性的43例PMSAH患者，2周左右复查DSA或320排CT血管造影，结果仍为阴性。所有病例均治愈出院，住院期间未发生再出血。43例出院后均随访6～12个月无再出血发生。结论PMSAH是一种预后佳，临床症状较轻、并发症少、主要位于脑干前方而病因不明的蛛网膜下腔出血。Objective To explore the clinical features, treatment and prognosis of patients with perimesencephalie nonaneurysmal subarachnoid hemorrhage （PMSAH）. Methods The clinical data of 43 patients with PMSAN who admitted to our hospital from December, 2011 to November 2012 were analyzed retrospectively. Results CT within 48 hours after the hemorrhage showed that there was SAH in all the patients. The outcomes of digital subtraction angiography of the cerebral vessels within 72 hours after the hemorrhage were megative in all patients. Two weeks later, 2 patients and 41 patients were reexamined by digital subtraction angiography and 320-slice CT angiography, respectively and the outcomes in all the patients also were negative. All the patients received conservative treatment. All the patients were followed up from 6 months to 12 months. No rebleeding occurred in all patients, who were recovered well. Conclusions PMSAH is vasculogenic disease with equivocal pathogenicity. There are slight symptoms less complications, low rate of rebleeding and good prognosis in the patients with PMSAH.

关 键 词：中脑周围非动脉瘤性蛛网膜下腔出血 临床特点 诊断 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学]