DSA阴性的蛛网膜下腔出血临床分析

The clinical characteristics in patients suffered from SAH with normal DSA results

目的 探讨 DSA阴性的蛛网膜下腔出血 (SAH)的病因、临床特点和预后。方法 回顾对比分析 3 0例 DSA阴性的 SAH及 10 2例 DSA阳性的 SAH的临床资料。结果 DSA阴性 SAH患者年龄偏大 ,精神症状多见 ,伴有高血压、高血脂多 ,而头痛相对较轻 ,脑神经损害、癫痫发作较少 ,出血量较小 ,再出血率、脑积水等并发症较少 ,死亡率较低 ,与 DSA阳性 SAH相比有显著差异。结论 DSA阴性 SAH临床表现不典型 ,症状相对较轻 ,易误诊 ,预后较好。 DSA阴性主要原因是环中脑池出血 (PNSH)、微小动脉瘤 ,少数可能为假阴性 ,必要时需行

ObjectiveTo investigate the etiology,th e clinical characteristics and the prognosis in patients suffered from subarachoid hemorrhage(SAH) with normal Digital Subtraction Angiography(DSA) results. MethodsTh e clinical materials in 30 cases of patients suffered from SAH with normal DSA results and 102 cases of patients with abnormal DSA results were analyzed retrospectively. ResultsThe patients suffered from SAH with normal DSA results were aged,with more mental s ymptom and hypertension and hyperlipidemia histories,but they had mild headach e,less cranial nerve influence,epilepsy attack and hemorrhage amount. Their complicati ons such as rehemorrhage and hydrocephalus were rare and the mortality from SAH was lower. There was significant difference from those patients of SAH with abnormal DSA results. ConclusionThe symptom in patients suffered from SAH with normal DSA results is slighter and untypical,easy to be misdiagnosed ,and the prognosis is better. The main causes are microaneurysm,perimesencepha lic Nonaneuryomal SAH(PNSH) and minority of them are false normal. So it is necessar y to repeate making DSA sometimes.