Subdural hematoma due to ruptured intracranial aneurysm.
Subdural hematoma due to ruptured intracranial aneurysm.
复制标题
颅内动脉瘤破裂导致硬膜下血肿。
DOI：
10.2176/nmc.31.82
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发表时间：
1991
影响因子：
1.9
通讯作者：
S. Monden
中科院分区：
文献类型：
--
作者：
K. Kamiya;T. Inagawa;M. Yamamoto;S. Monden
484 例动脉瘤性蛛网膜下腔出血 (SAH) 病例中，有 15 例观察到硬膜下血肿 (SDH)。其中男4例，女11例，年龄39岁至75岁。入院时的临床分级（Hunt 和 Hess）为 11 级（3 例）、III 级（2 例）、IV 级（4 级）和 V 级（6 级）。破裂动脉瘤位于大脑中动脉（MCA）6例，前交通动脉3例，颈内动脉2例，远端大脑前动脉（ACA）2例，其中2例未确诊。大部分动脉瘤发生在 MCA 和远端 ACA。 7例均在急性期行动脉瘤颈夹闭及SDH切除，术中无再破裂。七名接受手术的患者在SAH后1年的结果是，其中五名患者恢复良好，但两名患者由于术前再破裂或医疗并发症而处于植物人状态。未经手术干预的八名患者全部死亡。对于伴有 SDH 的颅内动脉瘤破裂患者，即使入院时的临床分级较差，在急性期直接进行手术干预也有望获得良好的预后。
Subdural hematoma (SDH) was observed in 15 of 484 cases of aneurysmal subarachnoid hemorrhage (SAH). There were four males and 11 females, with ages ranging from 39 to 75 years. The clinical grades (Hunt and Hess) on admission were 11 in three cases, III in two, IV in four, and V in six. The ruptured aneurysms were located in the middle cerebral artery (MCA) in six cases, anterior communicating artery in three, internal carotid artery in two, and distal anterior cerebral artery (ACA) in two, with two cases unconfirmed. A high proportion of aneurysms occurred in the MCA and distal ACA. Aneurysmal neck clipping and removal of SDH were performed in the acute stage of seven cases, without intraoperative rerupture. The outcomes 1 year after SAH of the seven patients undergoing surgery were good recovery in five, but in two, vegetative state due to preoperative rerupture or medical complications. All eight patients without surgical intervention died. A good prognosis for patients with ruptured intracranial aneurysms accompanied by SDH can be expected with direct surgical intervention in the acute stage, even if the clinical grade on admission is poor.