创伤性脑动脉瘤延迟破裂的临床特征和危险因素:一个病例系列
Masataka Sugii1,2, Kazuhiro Okada1,2, Shimpei Ikeda1,2
1Nippon Medical School Chiba Hokusoh Hospital Chiba Japan.
Acute medicine & surgery
|August 23, 2024
概括
创伤性脑动脉瘤 (TA) 的延迟破裂可能是致命的. 怀疑 TA 患有急性腹腔内血瘤和内血瘤扩张,并考虑在第 5 天左右对头部受伤患者进行查.
科学领域:
- 神经外科 神经外科
- 神经辐射学神经辐射学
- 创伤学 创伤学 创伤学
背景情况:
- 创伤性脑动脉瘤 (TA) 是创伤性脑血管损伤 (TCVI) 的一个关键子集.
- 错误诊断或延迟诊断TA可能导致致命的结果.
- 这项研究调查了TA形成的预测因素和最佳查时间.
研究的目的:
- 为了确定预测创伤性脑动脉瘤形成的因素.
- 确定查创伤性脑动脉瘤的最佳时间.
- 在住院期间报告延迟创伤性脑动脉瘤破裂.
主要方法:
- 在2021年4月至2022年3月期间,对头部受伤患者延迟TA破裂的医疗记录进行了回顾性审查.
- 分析初始成像检测结果 (急性脑下血液瘤 - ASDH) 和重复成像 (创伤性脑下关节出血 - tSAH扩张).
- 对患者管理的审查,包括使用抗凝剂.
主要成果:
- 在住院期间发现了四起延迟TA破裂的病例.
- 只有一个患者符合现有的TCVI查标准.
- 所有患者呈现ASDH;两人显示tSAH延迟扩张.
- 在住院5日和11日之间发生了TA破裂.
- 所有患者都服用抗凝药.
- 三名患者在住院期间死亡.
结论:
- 疑似创伤性脑动脉瘤 (TA) 在急性体内血瘤患者的入院和内血瘤扩张.
- 在高危患者中,考虑在医院5日左右对TA进行查.
- 早期发现和管理对于改善创伤性脑血管损伤的结果至关重要.
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