孤立性大脑凸面蛛网膜下腔出血的病因课件.ppt

1、1孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022病因病因2孤立性大脑凸面蛛网膜下腔出血的病因10/19/20223孤立性大脑凸面蛛网膜下腔出血的病因10/19/20224孤立性大脑凸面蛛网膜下腔出血的病因10/19/20225孤立性大脑凸面蛛网膜下腔出血的病因10/19/20226孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022 Vascular MalformationsSimilarly,cavernomas are rarely described as a cause of SAH.However,superficial and leptomeningeal cavern

2、omas may be the source of cSAH.7孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022 RCVS8孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022 RCVS9孤立性大脑凸面蛛网膜下腔出血的病因10/19/202210孤立性大脑凸面蛛网膜下腔出血的病因10/19/202211孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022 Vasculitides12孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022 Vasculitides13孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022Infectious OriginCortical SAH may

3、 be seen after rupture of infectious aneurysms(caused by infective endocarditis,meningitis,or rarely crypto-genically)(Fig 5).Headache is diffuse and vague,rather than thetypical excruciating 极痛苦极痛苦headache of noninfectious aneurysmal SAH.Usually,there are also general symptoms(eg,anorexia,weight lo

4、ss,malaise,or fever)14孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022nIn infective endocarditis,MR imagingnmight show associated lesions(ischemic,microbleeds,brain abscesses).DSA might be used for the diagnosis of distal arterial lesions and for therapeutic purposes.Infectious Origin15孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022Infecti

5、ous Origin16孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022Infectious Origin17孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022MoyamoyaAccording to a recent classification,patients with well recognized associated conditions(eg,sickle cell disease，neurofibromatosis type 1,cranial therapeutic irradiation,and Down syndrome)are considered as ha

6、ving a Moyamoya syndrome,while patients with no known associated risk factors are said to have Moyamoya disease18孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022Moyamoya19孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022High-Grade Stenosis20孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022Fig 6.Pial vasodilation.A,Axial GRE T2 image shows a left frontal sulcal SA

7、H(black arrowhead),possibly located in the“watershed”territory between the anterior and the middle cerebralarteries.B,Axial maximum-intensity-projection reconstruction of CTA shows an asymmetry of the distal arteries,in favor of left pial vasodilation.C,Frontal projection of 3D angiographyof the lef

8、t carotid artery reveals a severe stenosis at the origin of the M2 branch(white arrowhead).21孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022Fig.1 A CT demonstrates a left inferior temporal SAH.B This is confirmed on MRI.C Several areas of restricted diffusion are seen in the left MCA region.D Angiography demonstrates t

9、ight bilateral internal carotid stenoses22孤立性大脑凸面蛛网膜下腔出血的病因10/19/202223孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022posterior reversible encephalopathy syndrome24孤立性大脑凸面蛛网膜下腔出血的病因10/19/202225孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022cerebral amyloid angiopathy26孤立性大脑凸面蛛网膜下腔出血的病因10/19/202227孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022cerebral amyloi

10、d angiopathy28孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022A,Axial brain CT scan shows a subtle left rolandic hyperattenuation favoring minimal SAH(white arrowhead).B and C,Axial GRE T2 images show left temporal lobarhemorrhage,multiple microbleeds,and cortical hemosiderosis.D,Axial FLAIR image obtained after 7 months shows a new asymptomatic SAH in a left parietal sulcus(white arrowhead),which was previously normal(see B)29孤立性大脑凸面蛛网膜下腔出血的病因10/19/202230孤立性大脑凸面蛛网膜下腔出血的病因10/19/202231孤立性大脑凸面蛛网膜下腔出血的病因10/19/2022