延迟致病性动脉瘤检测的风险分层和长期结果在血管学上是负的自发性脑下关节下出血
Jie Wang1, Jian-Feng Meng1, Shuo Wang1
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Stroke and vascular neurology
|January 31, 2024
概括
血管造影阴性子arachnoid出血 (anSAH) 的糟糕结果的危险因素是不清楚的. 非周周脑血管造影阴性SAH (NPAN-SAH) 和初始损伤预测SAH患者的预后不佳和延迟动脉瘤检测.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 放射学 放射学是一门学科.
背景情况:
- 血管学上负面的甲状腺下部出血 (anSAH) 的不良结果的病因和危险因素仍然不清楚.
- 通过CT扫描证实SAH的诊断,CT扫描显示在初始数字减去血管学 (DSA) 上没有血管异常的下大脑下出血.
研究的目的:
- 在SAH患者中确定延迟动脉瘤检测的危险因素.
- 为了确定非动脉瘤性SAH患者的不良结果的预测因素.
主要方法:
- 对前性维护的SAH患者数据库 (2014-2018) 的回顾性审查.
- 收集的数据包括病史,出血模式 (脑周血管图阴性SAH (PAN-SAH) 与非PAN阴性SAH (NPAN-SAH),修改的费舍尔尺度 (mFS),格拉斯哥昏迷评分 (GCS),亨特-赫斯等级和修改的兰金尺度 (mRS) 在随访时.
- 糟糕的结果被定义为3-6的mRS得分.
主要成果:
- 在303名患者中检测到21个动脉瘤 (7.7%),在NPAN-SAH和mFS 3-4组中检测率更高.
- 在非动脉瘤的SAH患者中 (n=251),18名 (7.2%) 经历了不良结果.
- NPAN-SAH和GCS 3-12与高率的SAH患者的不良结果有关.
结论:
- 患有NPAN-SAH和mFS 3-4的患者需要对延迟动脉瘤检测进行监测,即使在最初的负DSA后也是如此.
- 在非动脉瘤的SAH病例中,NPAN-SAH和初始功能障碍 (GCS 3-12) 表明预后不佳.
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