未破裂动脉瘤夹闭术后的中脑周围非动脉瘤性蛛网膜下腔出血
Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage After Clipping of an Unruptured Aneurysm.
作者信息
Cho Kwang-Chun, Kim Jung-Jae, Hong Chang-Ki, Joo Jin-Yang, Kim Yong Bae
机构信息
Department of Neurosurgery, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, Korea.
Department of Neurosurgery, College of Medicine, Yonsei University, Gangnam Severance Hospital, Seoul, Korea.
出版信息
World Neurosurg. 2017 Jun;102:694.e15-694.e19. doi: 10.1016/j.wneu.2017.03.134. Epub 2017 Apr 5.
BACKGROUND
Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a benign form of subarachnoid hemorrhage with an excellent clinical outcome. The cause of PNSAH remains unknown. We report a case of PNSAH in a patient with a history of clipping of an unruptured aneurysm. PNSAH after clipping of an unruptured aneurysm is extremely rare.
CASE DESCRIPTION
A 56-year-old man with a history of clipping surgery for an unruptured aneurysm 10 months previously presented with severe headache. No precipitating causes were shown; however, the patient had been engaged in an exertional activity before the event. After conservative treatment, he was discharged home without any complication from the hemorrhage.
CONCLUSIONS
On the basis of this case report, clinicians should consider the possibility of PNSAH in a patient who had an unruptured aneurysm previously treated with clipping. Nevertheless, diagnostic workup can be more important than keeping in mind that a subarachnoid hemorrhage might be a PNSAH.
背景
脑周非动脉瘤性蛛网膜下腔出血（PNSAH）是一种良性蛛网膜下腔出血形式，临床预后良好。PNSAH的病因尚不清楚。我们报告一例有未破裂动脉瘤夹闭史患者发生PNSAH的病例。未破裂动脉瘤夹闭后发生PNSAH极为罕见。
病例描述
一名56岁男性，10个月前有未破裂动脉瘤夹闭手术史，现出现严重头痛。未发现诱发原因；然而，事件发生前患者曾从事体力活动。经保守治疗后，他出院回家，未出现出血相关并发症。
结论
基于本病例报告，临床医生应考虑曾接受未破裂动脉瘤夹闭治疗的患者发生PNSAH的可能性。尽管如此，诊断性检查可能比记住蛛网膜下腔出血可能是PNSAH更为重要。
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