自发性蛛网膜下腔出血全脑血管造影未见异常临床分析

目的　探讨自发性蛛网膜下腔出血 (SAH)全脑血管造影未见异常的病因及临床处理方法。方法　对1999年至 2 0 0 3年 6月间 5 4例全脑血管造影未见异常患者诊断治疗进行回顾性分析。结果　 5 4例患者中 13例获得明确诊断 ,通过重复全脑血管造影检查发现 1例右额叶脑动静脉畸形 ,1例右侧后交通动脉瘤 ,头颅MRI检查发现 2例隐惹性血管畸形 ,均经手术证实。手术探查发现 2例前交通动脉瘤 ,7例为脑动脉静畸形。结论　不明原因的自发性蛛网膜下腔出血 (SAH)全脑血管造影检查未见异常患者多为动脉瘤血栓形成 ,微小动脉瘤 ,瘤颈狭窄 ,血管痉挛及病变被血肿压迫不显影等。首次全脑血管造影未见异常应重复造影检查 ,并进一步行MRI、CT检查 ,对于反复同一部位出血或头颅CT、MRI扫描高度怀疑有病灶存在者均应行手术探查

Analysis of no signs whole-brain vessels angiography of spontaneous subarachnoid hemorrhage

Objective To explore the etiology and treatments of spontaneous subarachnoid hemorrhage no signs of whole-brain vessels angiography.Methods Analysis the fifty-four patients no signs of whole-brain vessels angiography,who were diagnosed and treated in HaiKou People hospital from 1999 to June 2003.Results In these patients,there are 1 right frontal arteriovenous malformation and 1 posterior communicating artery aneurysm conformed by another angiography,2 latent cerebrovascular malformation found by MRI scan and conformed by operation.Furthermore,2 anterior communicating artery aneurysm and 7 arteriovenous malformations were found by operation.Conclusions It is the microaneurysm,the narrow neck of aneurysm,the vessel spasm and the compression of hematoma,which insult in the spontaneous subarachnoid hemorrhage no signs of whole-brain vessels angiography.If no signs were found at first,another angiography,MRI scan or CT scan are necessary.Especially,All the suspected patients by MRI scan or CT scan and the others who were foud several hemorrhages at the same part in brain should have operated.