蛛网膜下隙出血首次全脑血管造影阴性的原因分析及处理

The cause and treatment of the negative results of initial aortocranial angiography in the patients with subarachnoid hemorrhage

目的探讨蛛网膜下隙出血(SAH)首次全脑血管造影阴性的原因及治疗策略。方法对我院28例首次全脑血管造影阴性的SAH患者的诊断、治疗进行回顾性分析。结果1例重复造影明确诊断,2例MRI确诊,6例重复造影仍阴性,15例PNSH未重复造影,其中14例随访时间1～3年,无1例再出血。结论首次造影阴性的SAH患者,除非明确为PNSH可不必重复DSA检查,其余须重复DSA检查,同时辅助行CT、MRI/MRA检查,必要时行CTA进一步检查。

Ohjective To explore the cause and treatment of the negative results of initial aortoeranial angiography in the patients with subarachnoid hemorrhage（SAH） . Methods To analyze retrospectively the diagnosis anti treatment of the 28 SAH patients whose resuhs were negative in the first-time aortocranial angiography in out hospital. Results 1 case was finally diagnosed by polysugraphy, and 2 cases were diagnosed by MRI,6 cases were still negative by polysography, 15 cases of PNSH were not treated by polysograph, 14 of which were followed up for 1 - 3 years, and no one was rehaemorrhagia. Conclusion The SAH patients whose first angiography shows a negative resuh should have the DSA examination once again,at the same time the CT, MRI,or MRA should be conducted as an adjutant one, and CTA should be further adopted if necessary, except the patients were diagnosed as PNSH.