中脑周围非动脉瘤性蛛网膜下腔出血26例临床分析

目的总结中脑周围非动脉瘤性蛛网膜下腔出血（PNSH）的临床特点。方法分析2006年10月一2008年4月我院收治的经CT证实并行全脑血管造影的PNSH26例的临床特点。结果所有患者均无意识丧失，无神经定位体征，Hunt—Hess分级Ⅰ～Ⅱ级，CT上出血部位在中脑周围的脑池，DSA检查均为阴性。采用对症治疗，未发生再出血、脑积水、继发性脑血管痉挛等并发症。结论PNSH临床表现平稳、恢复快、预后良好、并发症少。正确认识PNSH，可以缩短住院时间和减少重复脑血管造影，但首次诊断需行脑血管造影排除动脉瘤的可能。

Clinical analysis of 26 cases with perimesencephalic nonaneurysmal subarachnoid hemorrhage

Objective To summarize the clinical characteristics of perimeseneephalie nonaneurysmal subarachnoid hemorrhage （ PNSH ）. Methods Twenty-six patients of PNSH （ Oct. 2006 - Apr. 2008） were analysed and all patients were examined by CT and DSA. Results No loss of consciousness and focal neurological deficits were found in the 26 cases which were classified to Grade Ⅰ or Ⅱ by Hunt and Hess classification. In all the cases, the SAH located in the perimeseneephlie cistern by CT scan, and the negative results were also found by DSA imaging. Patients treated with symptomatic treatment were not found any complications such as rebleeding, symptomatic vasospasm, and hydrocephalus. Conclusions Patients with PNSH have even clinical condition, short-term convalescence, hopeful prognosis, and excellent results with less complications. It is important to make certain and correct diagnosis of PNSH to avoid repeated angiographie examination and shorten patients time of hospital stay. But cerebral angiography is necessary for first visit patients of PNSH to exclude the aneurysm.