孤立性大腦凸面蛛網(wǎng)膜下腔出血的病因課件

1、病因 Vascular MalformationsSimilarly, cavernomas are rarely described as a cause of SAH.However, superficial and leptomeningeal cavernomas may be the source of cSAH. RCVS RCVS Vasculitides VasculitidesInfectious OriginCortical SAH may be seen after rupture of infectious aneurysms(caused by infective e

2、ndocarditis, meningitis, or rarely crypto-genically) (Fig 5).Headache is diffuse and vague, rather than thetypical excruciating 極痛苦headache of noninfectious aneurysmal SAH.Usually, there are also general symptoms (eg, anorexia, weight loss, malaise, or fever)In infective endocarditis, MR imagingmigh

3、t show associated lesions (ischemic, microbleeds, brain abscesses).DSA might be used for the diagnosis of distal arterial lesions and for therapeutic purposes.Infectious OriginInfectious OriginInfectious OriginMoyamoyaAccording to a recent classification, patients with well recognized associated con

4、ditions (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 diseaseMoyamoyaHigh-Grade StenosisFig 6. Pial vasodilation. A, A

5、xial GRE T2 image shows a left frontal sulcal SAH (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 vasodi

6、lation. C, Frontal projection of 3D angiographyof the left carotid artery reveals a severe stenosis at the origin of the M2 branch (white arrowhead).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 left MCA reg

7、ion. D Angiography demonstrates tight bilateral internal carotid stenosesposterior reversible encephalopathy syndromecerebral amyloid angiopathycerebral amyloid angiopathyA, 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 m