自发性皮层蛛网膜下腔出血临床特点分析

发布时间：2018-05-04 16:05

  本文选题：自发性皮层蛛网膜下腔出血 + 头颅磁共振衰减反转恢复序列　； 参考：《郑州大学》2014年硕士论文

【摘要】：目的： 充分了解自发性皮层蛛网膜下腔出血（localized nontraumatic convexalsubarachnoid hemorrhage,atraumatic convexal subarachnoid hemorrhage，cSAH）的各种临床表现、典型影像学特征，探讨其发病原因及发生机制，指导临床工作中对此类患者的诊断及治疗，提高临床工作人员对此病的认识和重视程度。 方法： 分析我院近2年收治的确诊为cSAH的3例患者的临床资料，对此3例患者的各种不同临床表现、各种影像学资料、发病原因、治疗方案及预后情况进行分析，并结合文献资料进行总结，深入了解cSAH的临床特征。 结果： 3例患者均被头颅MRI FLAIR相明确诊断，临床症状分别为头痛、左上肢无力、头晕；发病原因分别为可逆性痉挛性脑血管病、烟雾病、淀粉样脑血管疾病；给予对症支持治疗后症状均消失；随访8～18个月均未再出现症状，随访期间复查CT和MRI未见异常。 结论： cSAH病因较多，是非动脉瘤性蛛网膜下腔出血的主要亚型，其在临床特点方面与典型的蛛网膜下腔出血有所不同，主要表现在临床表现多样，特异性差；影像学特点为出血局限在脑皮层表面沟回，出血量小；诊断主要依靠头颅MRIFLAIR相，，易漏诊误诊；治疗主要为对症治疗及病因治疗，预后一般较好。
[Abstract]:Objective: To fully understand the clinical manifestations, typical imaging features, pathogenesis and mechanism of spontaneous nontraumatic convexalsubarachnoid subarachnoid hemorrhage (SSAH), and to guide the diagnosis and treatment of these patients in clinical work. To improve the clinical staff understanding and attention to the disease. Methods: The clinical data of 3 cases of cSAH diagnosed in our hospital in recent 2 years were analyzed. The clinical manifestations, imaging data, etiology, treatment plan and prognosis of the 3 patients were analyzed. The clinical features of cSAH were further understood by summarizing the literature. Results: The clinical symptoms were headache, left upper limb weakness, dizziness, reversible spastic cerebrovascular disease, moyamoya disease and amyloid cerebrovascular disease. The symptoms disappeared after the treatment of symptomatic support, and no symptoms were found in the follow-up for 8 ~ 18 months. During the follow-up period, CT and MRI were not abnormal. Conclusion: The main subtypes of non-aneurysm subarachnoid hemorrhage in cSAH are different from typical subarachnoid hemorrhage in clinical features, mainly in the variety of clinical manifestations and poor specificity. The imaging features were that the hemorrhage was confined to the sulcus of the cerebral cortex and the amount of bleeding was small; the diagnosis mainly depended on the MRIFLAIR phase of the skull and was easy to be misdiagnosed; the treatment was mainly symptomatic treatment and etiological treatment, and the prognosis was generally good.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3


本文编号：1843649