Kayama T, Sugawara T, Sakurai Y, Ogawa A, Onuma T, Yoshimoto T
Department of Neurosurgery, Sendai National Hospital, Japan.
Acta Neurochir (Wien). 1991;108(1-2):34-9. doi: 10.1007/BF01407664.
This report describes our retrospective evaluation of CT features of the acute phase in 34 cases of ruptured cerebral aneurysms of the posterior cranial fossa. The results are as follows. 1. Examination of cisternal haematoma distribution revealed that SAH had extended to the supra- and infratentorial cisterns in 28 cases (82%). There were only 6 cases (18%) in which SAH was confined to the posterior cranial fossa only but even when there was subarachnoid haematoma in both the supra- and infratentorial cisterns, thick haematomas were seen at the periphery of the brain stem. In cases of vertebral artery-posterior inferior cerebellar artery aneurysms (VA-PICA AN), haematomas in the ambient cistern were thicker on the aneurysm side. In addition, in cases of basilar artery-bifurcation (BA-Bifurcation AN) and basilar artery-superior cerebelli artery aneurysms (BA-SCA AN), there were many thick, high-density haematomas in the interpeduncular cistern. 2. The rate of intracerebral haemorrhage was extremely low (1 patient). 3. The rate of intraventricular haemorrhage was high, and these haemorrhages demonstrated a reflux pattern. 4. The rate of hydrocephalus was high (76.5%) in comparison with that noted in association with SAH due to the rupture of anterior circulation aneurysms.
本报告描述了我们对34例后颅窝破裂脑动脉瘤急性期CT特征的回顾性评估。结果如下：1. 对脑池血肿分布的检查显示，28例（82%）蛛网膜下腔出血（SAH）扩展至幕上和幕下脑池。仅有6例（18%）SAH仅局限于后颅窝，但即使幕上和幕下脑池均有蛛网膜下腔血肿时，脑干周围也可见厚血肿。在椎动脉-小脑后下动脉动脉瘤（VA-PICA AN）病例中，环池内动脉瘤侧的血肿更厚。此外，在基底动脉分叉处（BA-Bifurcation AN）和基底动脉-小脑上动脉动脉瘤（BA-SCA AN）病例中，脚间池内有许多厚的高密度血肿。2. 脑内出血率极低（1例患者）。3. 脑室内出血率高，且这些出血表现为反流模式。4. 与前循环动脉瘤破裂所致SAH相比，脑积水发生率高（76.5%）。
