中脑周围非动脉瘤性蛛网膜下腔出血

Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage:15 Cases Report

目的进一步了解中脑周围非动脉瘤性蛛网膜下腔出血（PNSH）的临床影像学特点,结合文献复习,总结本病的发生、发展及转归。方法对我院诊治的15例PNSH患者观察其临床经过,来院24 h内行头CT检查,入院后分别行CT血管造影（CTA）和数字减影造影（DSA）检查。结果所有患者临床症状较轻,Hunt-Hess分级为1~2级,CT显示出血位于脑干周围脑池内。而CTA或DSA检查未见颅内动脉瘤和脑血管畸形。结论 PNSH为一种临床症状较轻,出血局限在脑干周围脑池内,预后良好的特殊类型蛛网膜下腔出血。

Objective Further to investigate the clinical and imaging features of perimesencephalic nonaneurysmal subarachnoid hemorrhage（PNSH） and discuss the pathogenesis,development and prognosis of PNSH.Methods 15 cases were retrospectively investigated,all cases in the group were examined by CT scan in 24 hours from onset,some cases the computed tomography angiography（CTA） and Digital subtraction angiography（DSA） were taken.Results All patients had slight clinical symptoms,whose Hunt and Hess scale were Grade I to II.All the CT scan revealed SAH located in the perimesencephlic cistern.The CTA and DSA did not show any positive finding of aneurysm or brain vascular malformations.Conclusion The PNSH was a distinct clinical entity,with a slight clinical symptoms,SAH located in the perimesencephlic cistern and had a good prognosis.