Kostić Aleksandar, Stojanov Dragan, Stefanović Ivan, Novak Vesna, Kostić Emina, Benedeto-Stojanov Daniela, Dragan Veselinović
Clinic for Neurosurgery, Clinical Centre of Nis, Nis, Serbia.
Srp Arh Celok Lek. 2012 Jan-Feb;140(1-2):8-13.
Subarachnoid haemorrhages (SAH) of unknown aetiology usually have a mild clinical presentation, favourable outcome and low complication rate.
The aim of this study was to analyse the complications in two forms of angiogram-negative spontaneous SAH: pretruncal (PNSAH) and nonpretruncal (NPNSAH).
The study group involved 18 patients with PNSAH and 16 patients with NPNSAH. CT scan was done within 72 hours from bleeding. All patients underwent four-vessel cerebral angiography. Repeat angiography was performed in five PNSAH and all NPNSAH patients.
Twenty-nine patients were in grade I or II of the Hunt-Hess Scale (17 PNSAH and 12 NPNSAH). There was one case of rebleeding (NPNSAH patient), 10 cases of transient acute hydrocephalus (4 PNSAH and 6 NPNSAH). Cerebral vasospasm visualized by angiographies in two NPNSAH patients was local and mild, but was not found in PNSAH patients. Acute electrocardiography changes were found in 19 patients (significantly more frequently in NPNSAH than in PNSAH, 12 and 7 patients, respectively; p = 0.037).
Cardiac problems following these types of SAH are more frequent than expected, and therefore cardiac monitoring is necessary.
病因不明的蛛网膜下腔出血（SAH）通常临床表现较轻，预后良好，并发症发生率低。
本研究旨在分析两种血管造影阴性的自发性SAH的并发症：脑干前型（PNSAH）和非脑干前型（NPNSAH）。
研究组包括18例PNSAH患者和16例NPNSAH患者。出血后72小时内进行CT扫描。所有患者均接受了全脑血管造影。5例PNSAH患者和所有NPNSAH患者进行了重复血管造影。
29例患者Hunt-Hess分级为I级或II级（17例PNSAH和12例NPNSAH）。有1例再出血（NPNSAH患者），10例短暂性急性脑积水（4例PNSAH和6例NPNSAH）。2例NPNSAH患者血管造影显示的脑血管痉挛为局限性且轻度，但PNSAH患者未发现。19例患者出现急性心电图改变（NPNSAH患者明显多于PNSAH患者，分别为12例和7例；p = 0.037）。
这类SAH后的心脏问题比预期更常见，因此有必要进行心脏监测。
