Nonaneurysmal nonperimesencephalic subarachnoid hemorrhage: is it a benign entity?
Nonaneurysmal nonperimesencephalic subarachnoid hemorrhage: is it a benign entity?
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DOI：
10.1016/j.surneu.2008.04.021
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发表时间：
2009-05-01
影响因子：
--
通讯作者：
Mathuriya, Suresh N.
中科院分区：
文献类型：
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作者：
Gupta, Sunil K.;Gupta, Rahul;Mathuriya, Suresh N.
背景：虽然PMN型SAH患者的临床资料有很好的记录，但对于非动脉瘤性n-PMN型SAH患者的资料很少。在目前的研究中。分析n-PMN型SAH患者的临床特点，并与PMN型SAH和动脉瘤性SAH进行比较。方法：自发性SAH患者，初始DSA或三维CTA结果正常，进行另一项调查（CTA/DSA）。如果这两项结果均为阴性，则在4至6周后进行第二次DSA。即使是第二次DSA也未能显示动脉瘤或任何其他血管异常的患者被标记为非动脉瘤性SAH。在这一组中，确定了两种不同的类型：PMN型SAH和n-PMN型SAH。结果：61例患者首次DSA和CTA均为阴性。其中2例患者在第二次DSA检查中发现动脉瘤。7名患者在第二次DSA之前死亡。排除这些后，有18例为PMN型SAH， 34例为n-PMN型SAH。这些病人没有死亡；在平均1.8年的随访中，所有PMN型SAH患者和94.1%的n-PMN型SAH患者预后良好。与动脉瘤性SAH患者相比，PMN型SAH和n-PMN型SAH患者的相关合并症更为常见。结论：一旦明确排除所有动脉瘤，n-PMN SAH患者预后良好，与PMN SAH一样，临床病程为良性。然而，第二次DSA是强制性的，以避免遗漏动脉瘤或任何其他血管病变。(C) 2009爱思唯尔公司版权所有。
Background: Although the clinical profile of patients with PMN SAH is well documented, there are scarce data available for patients with nonaneurysmal n-PMN SAH. In the present study. the clinical characteristics of patients with n-PMN SAH were analyzed and compared with those of PMN SAH and aneurysmal SAH.Methods: Patients with spontaneous SAH, in whom the initial DSA or 3-dimensional CTA result was normal, underwent another investigation (CTA/DSA). If the results of both of these were negative, a second\ DSA was done after 4 to 6 weeks. Patients in whom even the second DSA failed to reveal an aneurysm or any other vascular abnormality were labeled as nonaneurysmal SAH. Within this group, 2 different types were identified: PMN SAH and n-PMN SAH.Results: There were 61 patients in whom the results of the first DSA and CTA were both negative. In 2 of these patients, an aneurysm was demonstrated at a second DSA. Seven patients died before a second DSA could be done. After excluding these, there were 18 patients with PMN SAH and 34 with n-PMN SAH. There was no mortality in these patients; and at a mean follow-up of 1.8 years, all patients with PMN SAH and 94.1% of patients with n-PMN SAH had a good outcome. Associated comorbid illnesses were more frequent in patients with PMN SAH and n-PMN SAH as compared with the aneurysmal SAH patients.Conclusions: Once all aneurysm is definitely excluded, patients with n-PMN SAH have a good outcome, and like PMN SAH, have a benign clinical course. However, a second DSA is mandatory to avoid missing an aneurysm or any other vascular lesion. (C) 2009 Elsevier Inc. All rights reserved.