孤立性大脑凸面蛛网膜下腔出血的病因精要.ppt

* 病因 Vascular Malformations Similarly, cavernomas are rarely described as a cause of SAH. However, superficial and leptomeningeal cavernomas may be the source of cSAH. RCVS RCVS Vasculitides Vasculitides Infectious 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 the typical excruciating 极痛苦headache of noninfectious aneurysmal SAH.Usually, there are also general symptoms (eg, anorexia, weight loss, malaise, or fever) In infective endocarditis, MR imaging might show associated lesions (ischemic, microbleeds, brain abscesses).DSA might be used for the diagnosis of distal arterial lesions and for therapeutic purposes. Infectious Origin Infectious Origin Infectious Origin Moyamoya According to a recent classification, 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 Moyamoya High-Grade Stenosis Fig 6. Pial vasodilation. A, Axial 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 vasodilation. 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 region. D Angiography demonstrates tight bilateral internal carotid stenoses pos