后交通动脉瘤破裂导致的无蛛网膜下腔出血或脑实质内血肿的急性硬膜下血肿：病例报告及文献复习
Acute subdural hematoma without subarachnoid hemorrhage or intraparenchymal hematoma caused by rupture of a posterior communicating artery aneurysm: case report and review of the literature.
作者信息
Mrfka Manuel, Pistracher Karin, Augustin Michael, Kurschel-Lackner Senta, Mokry Michael
机构信息
Department of Neurosurgery, Medical University Graz, Austria.
出版信息
J Emerg Med. 2013 Jun;44(6):e369-73. doi: 10.1016/j.jemermed.2012.11.073. Epub 2013 Apr 2.
BACKGROUND
Acute subdural hematoma without subarachnoid hemorrhage or intraparenchymal hematoma is rare.
CASE REPORT
We report on a 47-year-old women without previous trauma who presented with an acute subdural hematoma without subarachnoid hemorrhage. The hematoma was evacuated immediately. Further evaluation with a cerebral four-vessel angiography revealed a left-sided posterior communicating artery aneurysm that was occluded by endovascular embolization. The patient recovered without neurological deficit.
CONCLUSIONS
Ruptured intracranial aneurysm should be considered as a cause of nontraumatic subdural hematoma. Immediate subdural hematoma removal after aneurysm coiling can be performed in such patients, even those in poor neurological condition.
背景
无蛛网膜下腔出血或脑实质内血肿的急性硬膜下血肿较为罕见。
病例报告
我们报告一例47岁女性，既往无外伤史，出现无蛛网膜下腔出血的急性硬膜下血肿。血肿立即被清除。进一步行全脑血管造影显示左侧后交通动脉瘤，通过血管内栓塞进行了闭塞。患者康复且无神经功能缺损。
结论
颅内动脉瘤破裂应被视为非创伤性硬膜下血肿的一个病因。对于此类患者，即使是神经功能状态较差的患者，在动脉瘤栓塞后也可立即进行硬膜下血肿清除术。
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