霹雳样头痛患者。

The Patient with Thunderclap Headache.

作者信息

Malhotra Ajay, Wu Xiao, Gandhi Dheeraj, Sanelli Pina

机构信息

Department of Radiology and Biomedical Imaging, Yale School of Medicine, The Imaging Clinical Effectiveness and Outcomes Research, Northwell Health, 55 York Street, New Haven, CT 06511, USA.

Department of Radiology and Biomedical Imaging, Yale School of Medicine, 55 York Street, New Haven, CT 06511, USA.

出版信息

Neuroimaging Clin N Am. 2018 Aug;28(3):335-351. doi: 10.1016/j.nic.2018.03.002. Epub 2018 Jun 8.

DOI:10.1016/j.nic.2018.03.002

PMID:30007749

Abstract

Thunderclap headache is a common presentation in the emergency department and, although multiple causes have been described, subarachnoid hemorrhage (SAH) is the primary concern and early diagnosis is critical. CT is highly sensitive if performed within 6 hours of onset. Patients with aneurysmal or perimesencephalic SAH should be evaluated with CT angiography. Further work-up should be guided by the pattern of blood. Patients with negative CT angiography may be further evaluated with MR imaging, especially patients with peripheral convexity SAH.

摘要

霹雳样头痛是急诊科常见的症状，尽管已描述了多种病因，但蛛网膜下腔出血（SAH）是主要关注点，早期诊断至关重要。如果在发病6小时内进行CT检查，其敏感性很高。患有动脉瘤性或中脑周围SAH的患者应进行CT血管造影评估。进一步的检查应以血液分布模式为指导。CT血管造影阴性的患者可能需要进一步进行磁共振成像检查，尤其是外周凸面SAH患者。