Sawin P D, Loftus C M
University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Am Fam Physician. 1997 Jan;55(1):145-56.
Spontaneous subarachnoid hemorrhage is usually the result of rupture of an intracranial saccular aneurysm or arteriovenous malformation. The hemorrhage is typically a cataclysmic event, heralded by severe headache, meningeal signs and neurologic dysfunction. About one-half of patients with aneurysmal rupture experience "sentinel headaches" days to weeks before a major hemorrhage. Diagnosis at this stage may permit treatment before the occurrence of a devastating neurologic event. Clinical suspicion of subarachnoid hemorrhage should be confirmed by computed tomographic evaluation. Initial treatment of patients with spontaneous subarachnoid hemorrhage includes resuscitation and/or stabilization, management of acute effects of the hemorrhage, and prompt referral for neurosurgical treatment.
自发性蛛网膜下腔出血通常是颅内囊状动脉瘤或动静脉畸形破裂的结果。出血通常是一场灾难性事件，以严重头痛、脑膜刺激征和神经功能障碍为先兆。约一半的动脉瘤破裂患者在大出血前数天至数周会经历“警示性头痛”。在此阶段进行诊断可在毁灭性神经事件发生前进行治疗。临床怀疑蛛网膜下腔出血应通过计算机断层扫描评估来确诊。自发性蛛网膜下腔出血患者的初始治疗包括复苏和/或稳定病情、处理出血的急性影响以及迅速转诊至神经外科进行治疗。
