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非动脉瘤性中脑周围蛛网膜下腔出血:临床和影像学特征

Nonaneurysmal perimesencephalic subarachnoid hemorrhage: clinical and imaging features

摘要目的 探讨非动脉瘤性中脑周围蛛网膜下腔出血(nonaneurysmal perimesencephalic subarachnoid hemorrhage, NAPSAH)的临床和影像学特征.方法 回顾性纳入NAPSAH患者,收集和分析患者的临床和影像学特征.结果 在同期收治的489例蛛网膜下腔出血患者中,共有23例(4.7%)经头颅CT和CT血管造影确诊NAPSAH,出血分布于桥前池4例(17.39%)、脚间池8例(34.78%)、环池7例(30.43%)和四叠体池4例(17.39%).2例患者转入他院治疗,其余21例患者均转归良好,无并发症和神经功能缺损.其中,17例改良Rankin量表评分为0分,4例为1分,主要为健忘、易怒、焦虑等主观症状,给予心理疏导和抗焦虑治疗后好转.结论 NAPSAH发病率较低;NAPSAH患者临床症状较轻,转归较好,无明显并发症.

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abstractsObjectiveTo investigate the clinical and imaging features of nonaneurysmal perimesencephalic subarachnoid hemorrhage (NAPSAH).MethodsThe patients with NAPSAH were retrospectively enrolled, and their clinical and imaging features were collected and analyzed.Results In 489 patients with subarachnoid hemorrhage treated over the same period, a total of 23 (4.7%) with NAPSAH were diagnosed with cranial CT and CT angiography.Subarachnoid blood centered in the prepontine cistern in 4 patients (17.39%), interpeduncular cistern in 8 (34.78%), ring pool in 7 (30.43%), and quadrigeminal cistern in 4 (17.39%).Two patients were transferred to other hospital for treatment, and the remaining 21 patients had a good outcome without complications and neurological deficits.Among them, the modified Rankin scale scores in 17 patient were 0, and 4 were 1.Their cardinal symptoms were forgetfulness, irritability, anxiety, and other subjective symptoms.They were improved after receiving psychological counseling and anti-anxiety treatment.ConclusionsThe incidence of NAPSAH is low.The clinical symptoms in patients with NAPSAH are mild, the outcomes are better without obvious complications.

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