脑血管造影阴性的自发性蛛网膜下腔出血

目的　探讨全脑血管造影 (DSA)阴性的自发性蛛网膜下腔出血 (SAH)的临床特征。方法　分析 30例DSA阴性的 SAH患者临床表现、CT特征、治疗及预后。结果　本组病例临床表现 :头痛 30例 ,呕吐 2 6例 ,脑膜刺激征阳性 2 8例 ,一过性意识障碍 4例 ,局灶性神经功能障碍 4例 ,所有病例均无严重并发症且全部治愈出院。 30例中中脑周围非动脉瘤性蛛网膜下腔出血 (PNSH) 18例。结论　 DSA阴性的 SAH患者临床症状轻 ,并发症少 ,预后好。其中 PNSH病人应避免重复造影 ,脑、脊髓 MRI对明确病因有一定帮助。

Spontaneous subarachnoid hemorrhage with DSA negative result

Objective To explore the clinical features of spontaneous subarachnoid hemorrhage with DSA negative result. Methods The clinical manifestation, CT, treatment and prognosis in 30 cases were analyzed. Results All 30 cases had headache, 26 (86.7%) vomiting, 28 (93.3%) meningeal irritation sign, 4 (13.3%) temporary coma and 4 (l 3.3%) focal neurologic deficits. We did not find any severe complications and all patients recovered completely. Of the 30 cases, 18 had perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH). Conclusion Spontaneous subarachnoid hemorrhage with DSA negative result is a distinct clinical entity, with few manifestations, a good prognosis and low rate of severe complications. Repeated angiography should be avoided for PNSH and MR1 may be helpful to define the etiological factors.