本文選題：自發(fā)性皮層蛛網(wǎng)膜下腔出血 + 頭顱磁共振衰減反轉(zhuǎn)恢復(fù)序列　； 參考：《鄭州大學(xué)》2014年碩士論文

【摘要】：目的： 充分了解自發(fā)性皮層蛛網(wǎng)膜下腔出血（localized nontraumatic convexalsubarachnoid hemorrhage,atraumatic convexal subarachnoid hemorrhage，cSAH）的各種臨床表現(xiàn)、典型影像學(xué)特征，探討其發(fā)病原因及發(fā)生機(jī)制，指導(dǎo)臨床工作中對此類患者的診斷及治療，提高臨床工作人員對此病的認(rèn)識(shí)和重視程度。 方法： 分析我院近2年收治的確診為cSAH的3例患者的臨床資料，對此3例患者的各種不同臨床表現(xiàn)、各種影像學(xué)資料、發(fā)病原因、治療方案及預(yù)后情況進(jìn)行分析，并結(jié)合文獻(xiàn)資料進(jìn)行總結(jié)，深入了解cSAH的臨床特征。 結(jié)果： 3例患者均被頭顱MRI FLAIR相明確診斷，臨床癥狀分別為頭痛、左上肢無力、頭暈；發(fā)病原因分別為可逆性痙攣性腦血管病、煙霧病、淀粉樣腦血管疾病；給予對癥支持治療后癥狀均消失；隨訪8～18個(gè)月均未再出現(xiàn)癥狀，隨訪期間復(fù)查CT和MRI未見異常。 結(jié)論： cSAH病因較多，是非動(dòng)脈瘤性蛛網(wǎng)膜下腔出血的主要亞型，其在臨床特點(diǎn)方面與典型的蛛網(wǎng)膜下腔出血有所不同，主要表現(xiàn)在臨床表現(xiàn)多樣，特異性差；影像學(xué)特點(diǎn)為出血局限在腦皮層表面溝回，出血量小；診斷主要依靠頭顱MRIFLAIR相，，易漏診誤診；治療主要為對癥治療及病因治療，預(yù)后一般較好。
[Abstract]:Objective: To fully understand the clinical manifestations, typical imaging features, pathogenesis and mechanism of spontaneous nontraumatic convexalsubarachnoid subarachnoid hemorrhage (SSAH), and to guide the diagnosis and treatment of these patients in clinical work. To improve the clinical staff understanding and attention to the disease. Methods: The clinical data of 3 cases of cSAH diagnosed in our hospital in recent 2 years were analyzed. The clinical manifestations, imaging data, etiology, treatment plan and prognosis of the 3 patients were analyzed. The clinical features of cSAH were further understood by summarizing the literature. Results: The clinical symptoms were headache, left upper limb weakness, dizziness, reversible spastic cerebrovascular disease, moyamoya disease and amyloid cerebrovascular disease. The symptoms disappeared after the treatment of symptomatic support, and no symptoms were found in the follow-up for 8 ~ 18 months. During the follow-up period, CT and MRI were not abnormal. Conclusion: The main subtypes of non-aneurysm subarachnoid hemorrhage in cSAH are different from typical subarachnoid hemorrhage in clinical features, mainly in the variety of clinical manifestations and poor specificity. The imaging features were that the hemorrhage was confined to the sulcus of the cerebral cortex and the amount of bleeding was small; the diagnosis mainly depended on the MRIFLAIR phase of the skull and was easy to be misdiagnosed; the treatment was mainly symptomatic treatment and etiological treatment, and the prognosis was generally good.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3


本文編號：1843649