原因不明的蛛网膜下腔出血

Subaraohnoid Hemorrhage of Unknown Cause

病因不明的蛛网膜下腔出血约占１５～２０％。本文报告２０例。患者均无高血压病史。临床上以突发头痛、脑膜刺激征阳性及常伴低钠血症为其特征。ＣＴ扫描出血主要在中脑周围池。全脑血管造影排除动脉瘤及ＡＶＭ。腰穿检查血性脑脊液确诊。采用反复腰穿、尼莫地平等非手术治疗。预后良好。

Subarchnoid hemorrhage(SAH) of unknown cause is about 15 to 20% in SAH. Wereported 20 cases with SAH of unknown causes. All patients didn't present hypertension history. Abrupt headache, meningismus and hyponatremia were the most typical clinical features in this group. CT scanning suggested that SAH was limited in cisterna surrounding middle brain. Four vessel cerebral angiographic examination ruled out the diagnosis of aneurysm and cerebral AVM.The diagnosis of SAH was confirmed by lumbar puncture (L.P.) exainination. Nonsurgicol treatment which inctuded using Nimodipin, drainning bloody C.S.F by L.P. and so on was the main methods for this kind of SAH. The prognosis of this SAH was better.