自发性脊髓蛛网膜下腔出血的病因和治疗方法探讨

Approach to the causes and therapy of spontaneous spinal subarachnoid hemorrhage

自发性脊髓蛛网膜下腔出血是一种少见疾病。本文报告８例，临床确诊脊髓动静脉畸形５例，高血压动脉硬化、中性粒细胞性白血病脊髓侵犯、霉菌性脊髓炎各１例。临床上以突发性腰背部疼痛为特征，并有脊髓损害症状以及头部症状。根据病史，结合腰穿检查血性脑脊液确诊。并通过椎管造影，ＣＴ扫描、ＭＲＩ检查及脊髓血管造影进一步明确病因。治疗上常采用外科手术、栓塞治疗、腰穿置换疗法，理疗及神经活化剂应用等。

Abstract Spontaneous spinal subarachnoid hemorrhage (SAH) is an uncommon illness. We reported 8 patients with spinal SAH in recent years.3 cases were male and 5 were female.Of the 8 patients, 5 cases had spinal arteriovenous malformation, one hypertensive spinal arteriosclerosis, one leukemia involving spinal cord and one mouldy myelitis. The characteristic symptom was the paroxysm of severe lumbar-back pain. All patients showed neurological deficits caused by spinal damage and 5patients showed intracranial symptoms such as headache. and papilledema. The dignosis was made by clinical manifestations. bloody CSF, and by spinal myelography. The further causative computerized tomography(CT)scanning, magnetic resonance imaging (MRI)and selective spinal angiography. The methods of the treatment included operation, endovascular embolization, appropriately exchanging bloody CSF with normal saline solution by lumbar puncture.