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The Spectrum of Nontraumatic Convexity Subarachnoid Hemorrhage

机译:非创伤性凸性蛛网膜下腔的光谱

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Background: Nontraumatic convexity subarachnoid hemorrhage (cSAH) is a nonaneurysmal variant that is associated with diverse etiologies. Methods: With IRB approval, we retrospectively reviewed consecutive nontraumatic cSAH from July 1, 2006 to July 1, 2016. Data were abstracted on demographics, medical history, neuroimaging, etiology, and clinical presentation. Results: We identified 94 cases of cSAH. The cases were classified according to the following etiologies: reversible cerebral vasoconstriction syndrome (RCVS) 17 (18%), cerebral amyloid angiopathy (CAA) 15 (16%), posterior reversible encephalopathy syndrome 16 (17%), cerebral venous thrombosis 10 (11%), large artery occlusion 7 (7%), endocarditis 6 (6%), and cryptogenic 25 (27%). Early rebleeding occurred in 9 (10%) patients. Time from initial imaging to CT rebleeding was 40 hours (range, 5-74). CAA was associated with the highest mean age at 75.8 and RCVS the lowest at 47.6 years (P< .0001). Among patients with RCVS, initial vascular imaging was negative in 6 (35%), and repeat imaging documented vasoconstriction at a mean delay of 5 days (range, 3-16). Conclusion: There were significant differences among the subgroups in cSAH, with CAA presenting as older men with transient neurological deficits, and RCVS presenting as younger women with thunderclap headache. Rebleeding was seen in 10% of cSAH patients. One-third of RCVS patients with cSAH required repeat vascular imaging to diagnose vasoconstriction.
机译:背景:非创伤性凸性蛛网膜下腔出血(CSAH)是一种与不同的病因相关的腹腔瘤变体。方法:凭借IRB批准,我们回顾性地从2006年7月1日至2016年7月1日开始审查了连续的非创率CSAH。数据被提高了人口统计数据,病史,神经影像,病因和临床介绍。结果:我们确定了94例CSAH案例。这些病例根据以下病因分类:可逆脑血管收缩综合征(RCV)17(18%),脑淀粉样血管病(CAA)15(16%),后逆转脑病综合征16(17%),脑静脉血栓形成10( 11%),大动脉闭塞7(7%),心内膜炎6(6%)和密码发生25(27%)。早期再交,9例(10%)患者发生。从初始成像到CT Rebleeding的时间为40小时(范围,5-74)。 CAA与75.8的最高平均年龄有关,而RCV在47.6岁处最低(P <.0001)。在RCVS患者中,初始血管成像在6(35%)中为负,并且在5天的平均延迟(范围3-16)的平均延迟中重复成像血管收缩。结论:CSAH的亚组之间存在显着差异,CAA呈现为具有短暂神经系统缺陷的年龄较大的男性,以及作为雷霆头痛的年轻女性的RCVS。在CSAH患者的10%中看到了Rebebleeding。 CSAH患者的三分之一的RCV患者需要重复血管成像以诊断血管收缩。

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