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伴有血友病 C 的非动脉瘤性前颅底蛛网膜下腔出血。

Pretruncal Nonaneurysmal Subarachnoid Hemorrhage with Underlying Hemophilia C.

机构信息

National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.

National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia; Prince Mohammed Medical City, Aljouf, Saudi Arabia.

出版信息

World Neurosurg. 2019 Jul;127:109-112. doi: 10.1016/j.wneu.2019.03.278. Epub 2019 Apr 4.

Abstract

BACKGROUND

Pretruncal nonaneurysmal subarachnoid hemorrhage (PNSAH) accounts for 15%-12% of all case of subarachnoid hemorrhage. Its precise etiology is not yet established. Multiple theories and risk factors have been investigated to address the possible cause of this type of hemorrhage including basilar tip dissecting aneurysms, high spinal arteriovenous fistula, venous stenosis/hypertension or venous bleeding. Hereditary coagulopathies and hemophilias have rarely been reported in the literature as a potential cause of PNSAH.

CASE DESCRIPTION

Here, we reported a rare case of PNSAH with negative angiogram and magnetic resonance imaging who was also found to have hemophilia C (factor XI deficiency) confirmed by laboratory investigation. We also included a literature review of hereditary coagulopathies and their role as a possible cause of PNSAH.

CONCLUSIONS

Detailed medical history and physical examination of patients with PNSAH may lead to further hematologic evaluation for this group of patients, as in this case, and may reveal more cases of mild coagulopathy that require treatment.

摘要

背景

前交通非动脉瘤性蛛网膜下腔出血(PNSAH)占所有蛛网膜下腔出血病例的 15%-12%。其确切病因尚未确定。为了解决这种类型出血的可能原因,已经研究了多种理论和危险因素,包括基底动脉尖部夹层动脉瘤、高脊髓动静脉瘘、静脉狭窄/高压或静脉出血。遗传性凝血障碍和血友病在文献中很少被报道为 PNSAH 的潜在原因。

病例描述

在这里,我们报告了一例罕见的 PNSAH 病例,血管造影和磁共振成像均为阴性,实验室检查证实患者还患有血友病 C(因子 XI 缺乏症)。我们还对遗传性凝血障碍及其作为 PNSAH 可能病因的作用进行了文献复习。

结论

对 PNSAH 患者进行详细的病史和体格检查可能会导致对这组患者进行进一步的血液学评估,就像本例患者一样,可能会发现更多需要治疗的轻度凝血障碍病例。

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