孤立性大脑凸面蛛网膜下腔出血病因.pptVIP

孤立性大脑凸面蛛网膜下腔出血病因 2 病因3 4 5 6 7 Vascular MalformationsSimilarly, cavernomas are rarely described as a cause of SAH.However, superficial and leptomeningeal cavernomas may be the source of cSAH. 8 RCVS9 RCVS10 11 12 Vasculitides13 Vasculitides14 Infectious OriginCortical 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 thetypical excruciating 极痛苦headache of noninfectious aneurysmal SAH.Usually, there are also general symptoms (eg, anorexia, weight loss, malaise, or fever)15 In infective endocarditis, MR imagingmight show associated lesions (ischemic, microbleeds, brain abscesses).DSA might be used for the diagnosis of distal arterial lesions and for therapeutic purposes.Infectious Origin16 Infectious Origin17 Infectious Origin18 MoyamoyaAccording 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 disease19 Moyamoya20 High-Grade Stenosis21 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).22 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 ti