Seiler R W, van Gijn J
Neurochirurgische Universitätsklinik, Inselspital, Bern.
Ther Umsch. 1996 Jul;53(7):585-9.
The rupture of a cerebral aneurysm is the main cause of a spontaneous subarachnoid hemorrhage. Complications after the initial hemorrhage are recurrent bleeds, hydrocephalus and ischemia. Main symptom of a subarachnoid hemorrhage is the sudden, intense headache, often followed by loss of consciousness. The diagnosis is made by CT. If the CT is negative, lumbar puncture has to be performed, because in 5% of patients the blood may not be seen on the CT. If the diagnosis is confirmed, the patients has to be transferred as an emergency to a neurosurgical center. If his condition is satisfactory, the aim of the treatment is to occlude the ruptured aneurysm by microsurgical technique within the first three days after the hemorrhage. In patients with high surgical risk or bad general condition, the aneurysm can also be treated by the interventional neuroradiologist with endovascular techniques.
脑动脉瘤破裂是自发性蛛网膜下腔出血的主要原因。初次出血后的并发症包括再出血、脑积水和缺血。蛛网膜下腔出血的主要症状是突发剧烈头痛，常伴有意识丧失。诊断依靠CT。如果CT结果为阴性，则必须进行腰椎穿刺，因为5%的患者CT上可能看不到血液。如果确诊，患者必须作为急诊转至神经外科中心。如果患者情况良好，治疗目标是在出血后的头三天内通过显微外科技术闭塞破裂的动脉瘤。对于手术风险高或全身状况差的患者，神经介入放射科医生也可以采用血管内技术治疗动脉瘤。
