Patel Kalpesh C, Finelli Pasquale F
Department of Neurology, Hartford Hospital, Hartford, and University of Connecticut School of Medicine, CT 06102-5037, USA.
Neurocrit Care. 2006;4(3):229-33. doi: 10.1385/NCC:4:3:229.
Catheter angiography is performed to exclude aneurysm as the cause of subarachnoid hemorrhage (SAH). Certain categories of SAH however are for the most part nonaneurysmal and the risk of catheter angiography not justified. Primary convexity SAH may be nonaneurysmal and adequately investigated noninvasively.
Determine if primary convexity SAH is nonaneurysmal in origin.
Five new cases with primary convexity SAH and seven from the literature are reviewed for etiology, diagnostic studies, and outcome.
Diagnostic investigations included catheter angiography in 6 patients, MR in 11 patients, computed tomography (CT) in 10 patients, magnetic resonance angiography/magnetic resonance venography in 7 patients, CT angiography in 1 patient, and outcome of the 12 patients was benign without subsequent hemorrhage.
No case of primary convexity SAH was caused by aneurysm and outcome was benign in all patients, suggesting a noninvasive evaluation is adequate to investigate this condition.
进行导管血管造影以排除动脉瘤作为蛛网膜下腔出血(SAH)的病因。然而,某些类型的SAH在很大程度上是非动脉瘤性的,导管血管造影的风险并不合理。原发性凸面SAH可能是非动脉瘤性的,可通过无创检查进行充分评估。
确定原发性凸面SAH是否起源于非动脉瘤。
回顾了5例新发原发性凸面SAH病例和7例文献报道病例的病因、诊断研究及结果。
诊断性检查包括6例患者进行了导管血管造影,11例患者进行了磁共振成像(MR),10例患者进行了计算机断层扫描(CT),7例患者进行了磁共振血管造影/磁共振静脉造影,1例患者进行了CT血管造影,12例患者的结局良好,无后续出血。
原发性凸面SAH无一例由动脉瘤引起,所有患者结局良好,提示无创评估足以对这种情况进行检查。