晚期脑梗塞在低等级的甲状腺下出血. 特性,预测因素和临床影响
Andrea M Alexandre1, Anselmo Caricato2,3, Alessandro Pedicelli1,3
1UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy.
Neurosurgical review
|August 26, 2025
概括
晚期脑梗塞 (CI) 在低度脑下动脉动脉出血 (aSAH) 患者的预测是前部沟通动脉动脉瘤,SAH体积和需要DSA治疗. 显著恶化结果,增加残疾和死亡率.
科学领域:
- 神经学
- 神经外科
- 放射学
背景情况:
- 动脉瘤下关节出血 (aSAH) 是一种严重的神经疾病.
- 低度aSAH患者面临重大风险,包括晚期脑梗塞 (CI).
- 了解CI预测因素和影响对于改善患者的结果至关重要.
研究的目的:
- 在低度的aSAH中确定延迟脑梗塞 (CI) 的预测因子.
- 评估CI对患者结果的临床影响.
- 分析CI体积与患者结局之间的关系.
主要方法:
- 从POGASH注册表中收集的前性数据的回顾性分析.
- 包括连续出现WFNS等级IV- V aSAH的患者.
- 将CI定义为在6周内出现的新的缺血病变,不包括与治疗相关的原因.
主要成果:
- 在532名低度aSAH患者中,CI发生在19. 9%.
- 预测CI的因素包括SAH体积,前交动脉动脉瘤 (ACoA) 和需要DSA治疗.
- 独立预测的CI增加了残疾 (aOR0. 59).
结论:
- ACoA动脉瘤,SAH体积和DSA治疗可以预测低度aSAH的CI.
- CI的体积范围是其对结果不利影响的主要因素.
- 在幸存者中,CI体积独立预测死亡率和残疾增加.
相关概念视频
Aneurysm II: Clinical Manifestations and Diagnostic Studies
593
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
593
Aneurysm III: Interprofessional Care
479
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
479
Hemorrhagic Stroke l: Introduction
41
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
41
Hemorrhagic Stroke ll: Pathophysiology
57
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
57
Brain Abscess l: Introduction
48
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
48
Cerebral Edema ll: Pathophysiology
31
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
31


