孤立性大脑凸面蛛网膜下腔出血的病因课件.ppt

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1、,1,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,1孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,病因,2,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,病因2孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,3,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,3孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,4,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,4孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,5,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,5孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022

2、,6,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,6孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,Vascular Malformations,Similarly, cavernomas are rarely described as a cause of SAH.However, superficial and leptomeningeal cavernomas may be the source of cSAH.,7,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Vascular Malformations,RCVS,8,孤立性大脑凸面蛛网膜下腔出血的病因

3、,12/17/2022,RCVS8孤立,RCVS,9,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,RCVS9孤立,10,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,10孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,11,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,11孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,Vasculitides,12,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Vasculiti,Vasculitides,13,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Vasculiti,Infe

4、ctious Origin,Cortical SAH may 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headache of noninfectious aneurysmal SAH.Usually, there are also genera

5、l symptoms (eg, anorexia, weight loss, malaise, or fever),14,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Infectious OriginCortical SAH,In infective endocarditis, MR imagingmight show associated lesions (ischemic, microbleeds, brain abscesses).DSA might be used for the diagnosis of distal arterial lesions and for t

6、herapeutic purposes.,Infectious Origin,15,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,In infective endocarditis, MR,Infectious Origin,16,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Infectious Origin16孤立性大脑凸面蛛网膜下,Infectious Origin,17,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Infectious Origin17孤立性大脑凸面蛛网膜下,Moyamoya,According to a recent classi

7、fication, patients with well recognized associated conditions (eg, sickle cell disease，neurofibromatosis type 1, cranial therapeutic irradiation, and Down syndrome) are considered as having a Moyamoya syndrome, while patients with no known associated risk factors are said to have Moyamoya disease,18

8、,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Moyamoya18孤立性大脑凸面蛛网膜下腔出血的病因10/,Moyamoya,19,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Moyamoya19孤立性大脑凸面蛛网膜下腔出血的病因10/,High-Grade Stenosis,20,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,High-Grade Stenosis20孤立性大脑凸面蛛网,Fig 6. Pial vasodilation. A, Axial GRE T2 image shows a left frontal sulcal SAH (bla

9、ck 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

10、left 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,12/17/2022,Fig 6. Pial vasodilation. A, A,Fig. 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 le

11、ft MCA region. D Angiography demonstrates tight bilateral internal carotid stenoses,22,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,Fig. 1 A CT demonstrates a le,23,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,23孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,posterior reversible encephalopathy syndrome,24,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,posterior revers

12、ible encephalo,25,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,25孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,cerebral amyloid angiopathy,26,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,cerebral amyloid angiopathy26孤,27,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,27孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,cerebral amyloid angiopathy,28,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,cerebral amy

13、loid angiopathy28孤,A, 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,12/17/2022,A, Axial brain CT scan shows a,30,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,30孤立性大脑凸面蛛网膜下腔出血的病因10/2/2022,谢谢！,31,孤立性大脑凸面蛛网膜下腔出血的病因,12/17/2022,谢谢！31孤立性大脑凸面蛛网膜下腔出血的病因10/2/202,