Does non-perimesencephalic type non-aneurysmal subarachnoid hemorrhage have a benign prognosis?
Does non-perimesencephalic type non-aneurysmal subarachnoid hemorrhage have a benign prognosis?
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DOI：
10.1016/j.jocn.2008.10.008
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发表时间：
2009-07-01
影响因子：
2
通讯作者：
Hamm, In-Suk
中科院分区：
文献类型：
--
作者：
Kang, Dong-Hun;Park, Jaechan;Hamm, In-Suk
我们回顾和比较非动脉瘤性蛛网膜下腔出血（SAH）患者的临床过程和长期预后，并在CT扫描上有无脑周围出血模式。在876例自发性SAH患者中，52例（5.9%）被诊断为非动脉瘤性SAH。根据CT扫描，23例患者的SAH被分类为脑实质周围非动脉瘤性SAH (PNSH)， 29例患者的SAH被分类为非脑实质周围性SAH （non-PNSH）。非pnsh组患者进一步分为弥漫性（19例）和局限性（10例）。我们对所有可能的患者在发作后至少1年进行了随访三维ct血管造影（3D-CTA）。急性脑积水发生率（8.7%）和血管造影血管痉挛发生率（0%）均低于非PNSH组（分别为37.9%和27.6%）。非pnsh组仅发生1例再出血。在发作一年后进行的随访3D-CTA未发现明显出血来源。所有非动脉瘤性SAH患者具有相似的良好的长期功能预后。根据我们的研究，非PNSH患者的临床病程比PNSH患者更复杂。然而，当PNSH和非PNSH在一系列二维和三维血管造影检查中显示正常时，在有限的情况下，他们的长期预后同样有利。2009爱思唯尔有限公司版权所有。
We reviewed and compared the clinical course and long-term prognosis of patients with non-aneurysmal subarachnoid hemorrhage (SAH) with and without a perimesencephalic pattern of hemorrhage on CT scan. In 876 patients with spontaneous SAH, 52 (5.9%) were diagnosed with non-aneurysmal SAH. Based on their CT scans, the SAH was classified as perimesencephalic non-aneurysmal SAH (PNSH) in 23 patients and non-perimesencephalic (non-PNSH) in 29 patients. The patients in the non-PNSH group were further divided into diffuse type (19 patients) and localized type (10 patients). We performed follow-up three-dimensional-CT angiography (3D-CTA) in all possible patients at least 1 year after the attack. The PNSH group had a lower rate of acute hydrocephalus (8.7%) and angiographic vasospasm (0%) complications than the non-PNSH group (37.9% and 27.6%, respectively). Only one case of rebleeding occurred in the non-PNSH group. No demonstrable source of bleeding was found on follow-up 3D-CTA, which was performed I year after the attack. All patients with non-aneurysmal SAH had similarly favorable long-term functional outcomes. Based on our study, patients with non-PNSH have a more complicated clinical course than those with PNSH. However, the long-term prognosis was similarly favorable for both the PNSH and non-PNSH in limited circumstances when they showed normal findings on a series of two-dimensional and 3D angiographic work-ups. (C) 2009 Elsevier Ltd. All rights reserved.