原发性动脉瘤性蛛网膜下腔出血5个月后，因新发动脉瘤破裂导致的致死性超早期蛛网膜下腔出血
Lethal Ultra-Early Subarachnoid Hemorrhage Due to Rupture of De Novo Aneurysm 5 Months After Primary Aneurysmatic Subarachnoid Hemorrhage.
作者信息
Walter Johannes, Unterberg Andreas W, Zweckberger Klaus
机构信息
Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
出版信息
World Neurosurg. 2018 May;113:316-319. doi: 10.1016/j.wneu.2018.02.093. Epub 2018 Feb 23.
BACKGROUND
Approximately 1% of all patients surviving rupture of a cerebral aneurysm suffer from a second aneurysmatic subarachnoid hemorrhage later in their lives, 61% of which are caused by rupture of a de novo aneurysm. Latency between bleedings is usually many years, and younger patients tend to achieve better outcomes from a second subarachnoid hemorrhage.
CASE DESCRIPTION
We report an unusual case of lethal ultra-early rupture of a de novo aneurysm of the anterior communicating artery only 5 months after the initial subarachnoid hemorrhage and complete coiling in a young, healthy male patient.
CONCLUSION
Despite complete aneurysm obliteration, young age, and good recovery, patients may be subjected to secondary subarachnoid hemorrhages from de novo aneurysms after only a few months of the initial bleeding. Early-control magnetic resonance angiography might hence be advisable.
背景
在脑动脉瘤破裂后存活的所有患者中，约1%在其生命后期会再次发生动脉瘤性蛛网膜下腔出血，其中61%是由新发动脉瘤破裂引起的。两次出血之间的间隔通常为数年，年轻患者往往能从第二次蛛网膜下腔出血中获得更好的预后。
病例描述
我们报告了一例不同寻常的病例，一名年轻健康男性患者在首次蛛网膜下腔出血并完全栓塞后仅5个月，前交通动脉新发动脉瘤就发生了致命的超早期破裂。
结论
尽管动脉瘤已完全闭塞，患者年轻且恢复良好，但在首次出血仅几个月后，仍可能因新发动脉瘤而发生继发性蛛网膜下腔出血。因此，早期进行磁共振血管造影检查可能是可取的。
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