Canhão P, Ferro J M, Pinto A N, Melo T P, Campos J G
Department of Neurology, Hospital ST, Maria, Lisbon, Portugal.
Acta Neurochir (Wien). 1995;132(1-3):14-9. doi: 10.1007/BF01404842.
van Gijn and co-workers identified "Perimesencephalic haemorrhage" (PM) as distinct, benign, non-aneurysmal subarachnoid haemorrhage. However, there is only one retrospective series of this entity outside the Netherlands.
to confirm (or not) the benign nature of perimesencephalic subarachnoid haemorrhage by evaluating its clinical course and long-term follow-up in a consecutive series of patients admitted to a University Hospital.
Patients with subarachnoid haemorrhage and negative cerebral angiography admitted between January 1985 and April 1992 were classified according to the distribution of blood on a CT scan performed within 72 hours after onset, in perimesencephalic and non-perimesencephalic haemorrhages. Demographic and clinical data (collected consecutively), complications and long-term follow-up (obtained by chart review and follow-up by mail) were compared in the two groups.
Seventy one cases, 36 perimesencephalic and 35 nonperimesencephalic were included. Sex and age distribution were similar in the two groups. A normal examination on admission was the rule in the perimesencephalic group. Only one patient with perimesencephalic haemorrhage had a complication--transient neurological signs during angiography--and there were no deaths or morbidity during follow-up. In the non-perimesencephalic group three patients rebleed, four developed hydrocephalus and two had delayed cerebral ischaemia. Mean duration of follow-up was 27.6 months for the perimesencephalic and 30.8 months for the non-perimesencephalic group. After discharge there was a fatal rebleed in the latter group. Fifteen percent of the subjects (11% of the perimesencephalic group and 20% of the non-perimesencephalic group) retired from work during the follow-up period. Headaches and depression were found in similar percentages (22-25%) in both groups.
This study confirms that perimesencephalic haemorrhage is a distinct entity within the larger group of subarachnoid haemorrhage with negative angiograms, with a good short term and long-term prognosis, and no need for repeated angiographic investigation.
范·吉恩及其同事将“脑周出血”（PM）确定为一种独特的、良性的、非动脉瘤性蛛网膜下腔出血。然而，在荷兰以外仅有关于该病症的一个回顾性系列研究。
通过评估一系列连续入住大学医院患者的临床病程和长期随访情况，确认（或否定）脑周蛛网膜下腔出血的良性本质。
将1985年1月至1992年4月期间收治的蛛网膜下腔出血且脑血管造影阴性的患者，根据发病后72小时内进行的CT扫描上血液的分布情况，分为脑周出血组和非脑周出血组。对两组的人口统计学和临床数据（连续收集）、并发症以及长期随访情况（通过病历审查和邮件随访获得）进行比较。
共纳入71例患者，其中36例为脑周出血，35例为非脑周出血。两组的性别和年龄分布相似。脑周出血组入院时检查通常正常。仅有1例脑周出血患者出现并发症——血管造影期间的短暂神经体征，随访期间无死亡或发病情况。在非脑周出血组，3例患者再次出血，4例发生脑积水，2例出现迟发性脑缺血。脑周出血组的平均随访时间为27.6个月，非脑周出血组为30.8个月。出院后，非脑周出血组发生了致命的再次出血。15%的受试者（脑周出血组为11%，非脑周出血组为20%）在随访期间退休。两组中头痛和抑郁的发生率相似（22% - 25%）。
本研究证实，脑周出血是血管造影阴性的较大组蛛网膜下腔出血中的一种独特病症，具有良好的短期和长期预后，无需重复进行血管造影检查。
