颅内动脉支架植入术后蛛网膜下腔出血的临床转归

The Clinical Outcome of Subarachnoid Hemorrhage after Intracranial Stenting

目的:探讨颅内动脉支架植入术后蛛网膜下腔出血(SAH)的发生原因和处理方法。方法:3例症状性大脑中动脉狭窄患者行支架植入术,术后即刻CT示SAH,立即停用抗凝、抗血小板集聚治疗,给予制动,控制血压和抗血管痉挛等治疗。结果:3例患者分别于术后11、7、10dCT示SAH吸收,恢复抗血小板集聚治疗,随访至今无异常。结论:颅内支架植入术后发生SAH机制复杂,及时有效处理后疗效满意。

Objective： To study the causes and treatment of subarachnoid hemorrhage （SAH） after intracranial stenting. Methods： Three patients with symptomatic stenosis of the middle cerebral artery underwent intracranial stenting. Occurrence of acute SAH after stenting was determined by immediate CT. Regular anticoagulation and antiplatelet therapy were immediately terminated. Bed rest, stabilizing the blood pressure and anti-vasospasm agents were applied. Results： The patients have recovered at days 11, 7 and 10 respectively after stenting. Antiplatelet treatment was required after recovery of the SAH. These patients in the follow-up presented no abnormalities. Conclusion： The causes of SAH after intracranial stenting were complicated. With appropriate and timely treatments, the prognosis was satisfactory.