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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Focal Neurological Deficit at Onset of Aneurysmal Subarachnoid Hemorrhage: Frequency and Causes
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Focal Neurological Deficit at Onset of Aneurysmal Subarachnoid Hemorrhage: Frequency and Causes

机译：动脉瘤性蛛网膜下腔出血发作时的局灶性神经功能缺损：频率和原因

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Background and Aim: Focal neurological deficit (FND) is a recognized presenting symptom of aneurysmal subarachnoid hemorrhage (SAH). However, little is known on how often aneurysmal SAH patients present with FND and what the responsible mechanisms are. The aim of this study was to examine the frequency and causes of FND at onset in aneurysmal SAH. Methods: We reviewed the records of consecutive aneurysmal SAH patients over 5 years and identified those who presented with FND. We developed several potential mechanisms for FND based on consensus between 2 separate evaluating neurologists. We then compared the characteristics of aneurysmal SAH patients who presented with and without FND. Logistic regression models were used to assess for association of FND with poor outcome. Results: Of a total of 213 patients, 10.3% presented with FND. The junction of the internal carotid and posterior communicating arteries was the most common aneurysm location in patients with FND (36.4%). Causes of FND at presentation were intraparenchymal hematoma in 45.5%, early cerebral infarction in 22.7%, parenchymal compression by subarachnoid thrombus in 18.2%, and seizure with Todd's paralysis in 13.6%. Patients with FND were older (P = .001) and had higher rates of in-hospital death and severe disability at discharge (P < .0001), compared to those without focal deficit. FND was independently associated with poor outcome (odds ratio: 4.62, confidence interval: 1.41-15.14; P = .01). Conclusion: One in every 10 aneurysmal SAH patients presents with FND. FND at presentation has diverse mechanisms, is not associated with a specific aneurysm location, and is independently associated with poor outcome.
机译：背景与目的：局灶性神经功能缺损（FND）是动脉瘤性蛛网膜下腔出血（SAH）的公认症状。但是，关于动脉瘤SAH患者出现FND的频率以及负责机制是什么还知之甚少。这项研究的目的是检查在动脉瘤性SAH中FND的发生频率和原因。方法：我们回顾了连续5年以上的SAH动脉瘤患者的记录，并确定了患有FND的患者。我们基于2位独立评估神经科医生之间的共识，开发了FND的几种潜在机制。然后，我们比较了有无FND的动脉瘤SAH患者的特征。 Logistic回归模型用于评估FND与不良结局的关联。结果：在总共213例患者中，有10.3％的患者表现为FND。颈内动脉和后交通动脉的交界处是FND患者中最常见的动脉瘤位置（36.4％）。出现FND的原因包括：实质内血肿占45.5％，早期脑梗死占22.7％，蛛网膜下血栓引起的实质压迫占18.2％，托德麻痹引起的癫痫发作占13.6％。与无局灶性缺陷的患者相比，FND患者年龄更大（P = .001），院内死亡和出院时严重残疾的发生率更高（P <.0001）。 FND与不良预后独立相关（赔率：4.62，置信区间：1.41-15.14; P = 0.01）。结论：每10例动脉瘤SAH患者中就有1例患有FND。呈现时的FND具有多种机制，与特定的动脉瘤位置无关，并且与不良预后独立相关。

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