[SAH—英文讲义.pptVIP

讲义——颅内动脉瘤 subarachnoid hemorrhage CCM (Critical care medicine) The second peoples hospital Foshan city 佛山市第二人民医院 黄永光 What is it? Subarachnoid hemorrhage Overview Subarachnoid hemorrhage (SAH) is a serious, life-threatening type of stroke caused by bleeding into the space surrounding the brain. A stroke occurs when the brain is deprived of oxygen because of an interruption of its blood supply. SAH can be caused by a ruptured aneurysm. SAH One-third of patients who suffer an SAH will survive with good recovery; one-third will survive with a disability; and one-third will die. Treatment focuses on stopping the bleeding, restoring normal blood flow, relieving the pressure on the brain, and preventing vasospasm. Anatomy A subarachnoid hemorrhage caused by a ruptured aneurysm. As blood fills the space between the brain and skull, a blood clot forms, causing increased pressure on the brain. Aneurysmclassification 先天性动脉瘤 感染性动脉瘤 外伤性动脉瘤 动脉硬化性动脉瘤 按形态分类 囊性动脉瘤 梭性动脉瘤 夹层动脉瘤 不规则型 按大小分类 小型：5mm 中型：5~10mm 大型：11~25mm 巨大型：25mm （*蛇形动脉瘤是巨大动脉瘤的一个亚型） 按部位分型 Willis环前循环动脉瘤 颈内动脉： 大脑前动脉 大脑中动脉 Willis环后循环动脉瘤 椎动脉 基底动脉 大脑后动脉 Willis环前循环动脉瘤 Willis环前循环动脉瘤 Willis环前循环动脉瘤 Willis环前循环动脉瘤 Willis环前循环动脉瘤 Willis环后循环动脉瘤 Willis环后循环动脉瘤 Willis环后循环动脉瘤 What are the symptoms? sudden onset of a severe headache (often described as the worst headache of my life) nausea and vomiting stiff neck sensitivity to light (photophobia) blurred or double vision loss of consciousness seizures What are the causes?  Aneurysm: a balloon-like bulge or weakening of an artery wall that ruptures, releasing blood into the subarachnoid space around the brain. Arteriovenous malformation (AVM): an abnormal tangle of arteries and veins with no capillaries in between. The weakened blood vessels can rupture and bleed. Who is affected? SAH occurs in 6 to 11 out of 100,000 people each year. Aneurysm rupture accounts for 50 to 80% of these cases. Women have a slightly higher