中脑周围非动脉瘤性蛛网膜下腔出血的临床特点

Clinical features of perimesencephalic nonaneurysmal subarachnoid hemorrhage

目的探讨中脑周围非动脉瘤性蛛网膜下腔出血(perimesencephalic nonaneurysmal subarachnoid hemorrhage,PNSAH)的临床特点。方法回顾性分析2007年1月-2017年1月我科收治的27例PNSAH患者的临床表现、影像学资料及诊疗情况。结果 27例PNSAH患者首次全脑数字减影血管造影(digital subtraction angiography,DSA)阴性,2周后复查DSA或脑CT血管造影(computed tomographic angiography,CTA)仍为阴性。住院期间所有患者病程呈良性过程,平均住院时间(13.5±3.2)天。随访7个月~10年,平均(5.2±3.1)年,无再出血,也没有局灶性神经功能缺损。结论 PNSAH是一类特殊的、具有良好的病程和预后的SAH,其并发症和后遗症较少。临床上需严格其诊断标准。

Objective To explore the clinical features of perimesencephalic nonaneurysmal subarachnoid hemorrhage （PNSAH）. Methods A retrospective analysis was performed on 27 patients with PNSAH admitted to our department from January 2007 to January 2017 to investigate their clinical manifestations and imaging findings, as well as the diagnosis and treatment of PNSAH. Results All the 27 patients had negative results on the first whole-brain digital subtraction angiography （DSA） , and also had negative results on DSA or computed tomography angiography of the brain performed two weeks later. All the patients had a benign course of disease during hospitalization, with a mean length of hospital stay of 13.5 ± 3.2 days. Follow-up was performed for 7 months to 10 years （ mean 5.2 ± 3.1 years） , and no rebleeding or focal neurological deficit was found. Conclusions PNSAH is a special type of SAH with a benign course and a good prognosis, and has few complications and sequelae; however, the diagnostic criteria for PNSAH should be strict in clinical practice.