全脑血管造影阴性的蛛网膜下腔出血的病因探讨

目的 探讨全脑血管造影阴性的多膜下腔出血（ＳＡＨ）的病因学特点及临床处理方法。方法 对１９９３￣１９９８年５０例全脑血管造影阴性患的诊断、治疗进行回顾性分析。结果 ５０例患中８例获明确诊断,通过重复全脑血管造影检查发现１例右颈内动脉Ｃ１－２段动脉瘤;ＭＲＩ检查发现３例隐匿性血管畸形,其中２例经手术证实;手术探查发现２例动脉瘤,１例动脉壶腹,１例中服静脉畸形。结论 首次脑血管造影检查阴性的ＳＡＨ

Etiology of Subarachnoid Hemorrhage with Negative Cerebral Pan-angiography

Objectives In this article, the etiology of subarachnoid hemorrhage(SAH) of 50 patients with cerebral negative pan-angiography was evaluated and the therapeutic measures were discussed. Method Clinical data from 50 cases, who diagnosed as SAH but their pan-angiography was negative, were analyzed retrospectively. Results Exact causes of SAH were found in 8 cases of these 50 patients. Aneurysm of the right internal carotid artery (C1-2) was discovered in one case after repeated the pan-angiography. Cryptic AVMs were detected by MRI in 3 cases, of whom, 2 were verified during surgery. Exploratory surgery fornd that two patients had intracranial ruptured aneurysms, one had arterial ampulae and one had venous malformation in the midbrain. Conclusions The authors suggested that, for patients of SAH with initial negative cerebral pan-angiography, re-examination might be necessary and MRI was indicated for most of these patients. In patients with signs of rebleeding at the same site or when abnormalities were found during CT or MRI examination, exploratory surgery should be considered.