中脑周围非动脉廇性蛛网膜下腔出血临床及影像学分析

The clinical and radiographic features of permesencephalic nonaneurysmal subarachnoid hemorrhage

目的本文主要探讨中脑周围非动脉瘤性蛛网膜下腔出血(PNSAH)的临床和影像学特征,以利于神经科临床工作。方法回顾分析2014-07—2016-06通辽市医院神经内科收治的中脑周围非动脉瘤性蛛网膜下腔出血患者21例作为临床资料,分析患者的临床症状、影像学特征及发病机制。结果所有患者均在入院后经头颅影像学CT及CTA确诊,出血部位分布于桥前池、脚间池、脚池、环池和四叠体池的不同部位,一般在多部位出现,治疗后转归良好,无并发症及神经功能缺损表现,4例患者出现健忘、易怒、焦虑等症状,考虑与患者主观因素有关。结论 PNSAH患者出血部位在中脑周围,发病率较低,临床症状较轻,预后较好,无明显并发症,目前仍原因不明,依然需要临床医生重视发病原因的检查。

Objective To investigate the clinical and radiographic features of perimesencephalic nonaneurysmal subarachnoid hemorrhage （PASAH）. Methods 21 patients with PASAH from 2014. 07 to 2016.06 in the Department of Neurology of our hos- pital were retrospective analyzed. The clinical symptoms,imaging characteristics and pathogenesis were analyzed. Results All pa- tients were diagnosed with CT and CTA when admitted, the hemorrhage were mostly distributed in different brain areas. The outcomes were relatively good and no complications and neural function defect were found. 4 patients had symptoms such as irritability,anxiety,which were related with the patients＇ subjective factors. Conclusion PNSAH has lower morbidity,Better clinical symptoms and outcomes, and no obvious complications. The etiology of PNSAH is still unknown and it is important for doctors to pay attention.