中脑周围出血后再出血：病例报告及文献复习。
Recurrent Bleeding After Perimesencephalic Hemorrhage: Case Report and Review of the Literature.
机构信息
Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, Montpellier, France.
Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, Montpellier, France.
出版信息
World Neurosurg. 2019 Sep;129:287-291. doi: 10.1016/j.wneu.2019.06.050. Epub 2019 Jun 15.
BACKGROUND
Perimesencephalic hemorrhage (PMH), a subtype of nonaneurysmal subarachnoid hemorrhage, is characterized by a typical pattern of localized hemorrhage on head computed tomography. PMH is usually associated with a benign clinical course, and a lower incidence of complications such as vasospasm and rebleeding.
CASE DESCRIPTION
We present the cases of a man aged 28 years and a woman aged 21 years with no relevant medical history who experienced recurrent, spontaneous episodes of PMH within the course of 7 days and 29 months. No precipitating causes were identified.
CONCLUSIONS
There are only a couple of case reports of recurrent PMH, some of which were defined questionably. We review the reported cases and discuss the possible causes and long-term outcomes. Neurointerventionalists and neurosurgeons should be aware that the risk of recurrent hemorrhage of PMH does exist, although it is rather low. Even after early or late rebleeding, prognosis of PMH is excellent.
背景
脑桥周围出血（PMH）是一种非动脉瘤性蛛网膜下腔出血的亚型，其头部计算机断层扫描（CT）表现为典型的局限性出血模式。PMH 通常与良性临床病程相关，并且发生血管痉挛和再出血等并发症的发生率较低。
病例描述
我们报告了两例病例，一例为 28 岁男性，一例为 21 岁女性，均无相关病史，在 7 天和 29 个月内反复发作自发性 PMH。未发现诱发因素。
结论
仅有少数复发性 PMH 的病例报告，其中一些定义不明确。我们回顾了已报道的病例，并讨论了可能的原因和长期结局。神经介入医师和神经外科医师应该意识到，尽管 PMH 再出血的风险较低，但确实存在这种风险。即使在早期或晚期再出血后，PMH 的预后也很好。
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