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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Spontaneous Spinal Subarachnoid Hemorrhage: Presentation and Outcome
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Spontaneous Spinal Subarachnoid Hemorrhage: Presentation and Outcome

机译：自发脊髓蛛网膜瘤出血：呈现和结果

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BackgroundSpontaneous spinal subarachnoid hemorrhage (SSAH) is a rare but serious condition that can lead to a variety of medical complications. MethodsUsing the Mayo Clinic Rochester database, consecutive patients admitted to the Mayo Clinic Rochester, Minnesota hospital with spontaneous SSAH (not iatrogenic or traumatic) between January 2000 and December 2015 were retrospectively reviewed. Demographic and clinical data and functional outcomes as categorized by the modified Rankin Scale (mRS) score at the time of discharge and at postadmission follow-up were assessed. ResultsEight patients (median age 70 years, range 51-87) were identified. Seven patients presented with acute back pain or headache. Seven patients had poorly controlled chronic hypertension. Two patients had vasculitis and 1 had an arteriovenous malformation. Complications included cord compression (n = 4), hyponatremia (n = 5), sulcal subarachnoid hemorrhage (n = 2), chronic arachnoiditis (n?=?1), vasospasm (n?=?1), ischemic infarct (n?=?1), and late cord ischemia (n = 1). All patients were managed medically including blood pressure control and repeat imaging. One patient had an aneurysm, which was embolized, and 2 received steroids for vasculitis. One patient died during hospitalization and 1 died within a week of discharge. Five patients had improved and 1 had unchanged mRS score at posthospitalization follow-up. ConclusionsSSAH should be considered in patients with sudden onset of severe back pain and headache, especially if as associated with lower extremity weakness or urinary retention. Our findings suggest that older patients with poorly controlled hypertension are at particular risk for spontaneous SSAH. In our study vascular anomalies were found in 25% of patients, vasculitis in 25%, hyponatremia in 63%, and cord compression in 50%. Cord compression may be managed conservatively. Mortality was 25% in the 3 months following the initial event, primarily due to other medical comorbidities.
机译：背景脊髓蛛网膜瘤出血（SSAH）是一种罕见但严重的病症，可以导致各种医疗并发症。 MethoSus审查了Mayo Clinic Rochester数据库，连续2000年1月至2015年1月至2015年12月间自发SSAH（非理性或创伤）明尼苏达州罗切斯特的连续患者进行回顾审查。评估了在出院时和临时后续随访时进行了改进的Rankin规模（MRS）分数的人口统计和临床资料和功能结果。结果患者（70岁70岁，范围51-87）。 7名患者患有急性背痛或头痛。 7名患者控制慢性高血压良好。两名患者患有血管炎，1例具有动脉畸形。并发症包括脐带压缩（n = 4），低钠血症（n = 5），硫酸蛛网膜瘤出血（n = 2），慢性蛛网膜炎（n？=Δ1），血管痉挛（n？=？1），缺血梗塞（n？ =？1），和后帘线缺血（n = 1）。所有患者在医学上进行管理，包括血压控制和重复成像。一名患者患有动脉瘤，栓塞，2个接受血管炎的类固醇。一名患者在住院期间死亡，1个在出院一周内死亡。五名患者有所改善，1个在PosthospInalization随访中没有改变的SRES得分。结论应在患者中突然出现严重背痛和头痛的患者，特别是如果与下肢弱点或泌尿保留相关。我们的研究结果表明，受控高血压较低的老年患者特别是自发SSAH的风险。在我们的研究中，血管异常在25％的患者中发现，血管炎25％，低钠血症63％，脐带压缩50％。可以保守绳索压缩。在初始事件之后的3个月内，死亡率为25％，主要是由于其他医疗合并症。

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