孤立性大腦凸面蛛網(wǎng)膜下腔出血的病因

第1頁第2頁病因第3頁第4頁第5頁第6頁第7頁VascularMalformationsSimilarly,cavernomasarerarelydescribedasacauseofSAH.However,superficialandleptomeningealcavernomasmaybethesourceofcSAH.第8頁RCVS第9頁RCVS第10頁第11頁第12頁

Vasculitides第13頁

Vasculitides第14頁InfectiousOriginCorticalSAHmaybeseenafterruptureofinfectiousaneurysms(causedbyinfectiveendocarditis,meningitis,orrarelycrypto-genically)(Fig5).Headacheisdiffuseandvague,ratherthanthetypicalexcruciating

極痛苦headacheofnoninfectiousaneurysmalSAH.Usually,therearealsogeneralsymptoms(eg,anorexia,weightloss,malaise,orfever)第15頁Ininfectiveendocarditis,MRimagingmightshowassociatedlesions(ischemic,microbleeds,brainabscesses).DSAmightbeusedforthediagnosisofdistalarteriallesionsandfortherapeuticpurposes.InfectiousOrigin第16頁InfectiousOrigin第17頁InfectiousOrigin第18頁MoyamoyaAccordingtoarecentclassification,patientswithwellrecognizedassociatedconditions(eg,sicklecelldisease，neurofibromatosistype1,cranialtherapeuticirradiation,andDownsyndrome)areconsideredashavingaMoyamoyasyndrome,whilepatientswithnoknownassociatedriskfactorsaresaidtohaveMoyamoyadisease第19頁Moyamoya第20頁High-GradeStenosis第21頁Fig6.Pialvasodilation.A,AxialGRET2imageshowsaleftfrontalsulcalSAH(blackarrowhead),possiblylocatedinthe“watershed”territorybetweentheanteriorandthemiddlecerebralarteries.

B,Axialmaximum-intensity-projectionreconstructionofCTAshowsanasymmetryofthedistalarteries,infavorofleftpialvasodilation.C,Frontalprojectionof3DangiographyoftheleftcarotidarteryrevealsaseverestenosisattheoriginoftheM2branch(whitearrowhead).第22頁Fig.1ACTdemonstratesaleftinferiortemporalSAH.BThisisconfirmedonMRI.CSeveralareasofrestricteddiffusionareseenintheleftMCAregion.DAngiographydemonstratestightbilateralinternalcarotidstenoses第23頁第24頁posteriorreversibleencephalopathysyndrome第25頁第26頁cerebralamyloidangiopathy第27頁第28頁cerebralamyloidangiopathy第29頁A,AxialbrainCTscanshowsasubtleleftrolandichyperattenuationfavoringminimalSAH(whitearrowhead).BandC,AxialGRET2imagesshowlefttemporallobarhemorrhage,multiplemicrobleeds,andcorticalhemosiderosis.D,AxialFLAIRimageobtainedafter7mon