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Stroke：脑凸面蛛网膜下腔出血对脑淀粉样血管病病情进展的影响

2015-05-12 李志行 译 MedSci原创

脑淀粉样血管病脑内出血蛛网膜下出血
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脑淀粉样血管病相关的皮质表面铁质沉着(cSS)可能提示后续脑内出血(ICH)的风险增加。我们希望确定与此相关联出血性事件的机制和顺序。研究方法：在9年的时间里，我们对明确患有自发性脑凸面蛛网膜下腔出血(cSAH) 的患者进行了进行了细致的临床和神经影像学数据的纵向分析。我们还对每一位患者进行了近距成像病理对照。研究结果：38位cSAH患者中（平均年龄，77±11岁），有29位(76%)患者在核磁共

脑淀粉样血管病相关的皮质表面铁质沉着(cSS)可能提示后续脑内出血(ICH)的风险增加。我们希望确定与此相关联出血性事件的机制和顺序。

研究方法：
在9年的时间里，我们对明确患有自发性脑凸面蛛网膜下腔出血(cSAH) 的患者进行了进行了细致的临床和神经影像学数据的纵向分析。我们还对每一位患者进行了近距成像病理对照。

研究结果：
38位cSAH患者中（平均年龄，77±11岁），有29位(76%)患者在核磁共振成像中呈现出脑淀粉样血管病的影像学特点。26位(68%)患者存在cSS。16位受试者接受了增强对比核磁共振成像。在所有增强对比扫描中溢出的元素钆都可在急性cSAH部位见到。在平均为期24±22 (范围在 1–78)个月的随访中，15位(39%)患者出现反复的cSAHs，14位(37%)患者出现脑叶的ICHs。在22为新ICHs患者中，17位患者出现在之前cSAHs或cSS的部位。重复的神经影像学检查发现cSAH的扩大至脑实质，4位患者出现脑叶ICH的加重。21位(55%)患者可见cSS的扩散，其中14位已出现反复的cSAHs。在尸检报告中，脑膜血管的渗出受脑淀粉样血管病的影响已被明确指出。

研究结论：
在脑淀粉样血管病中脑膜血管的外渗可能是引起运动皮质层反复出血的主要原因，进而导致cSS的扩散，提示该区域会增加在未来ICH中受损伤的可能。脑内出血的扩大也有可能直接源于cSAH的进展。

原始出处：
Markus Beitzke, Christian Enzinger, Gerit Wünsch, Martin Asslaber, Thomas Gattringer, and Franz Fazekas
Contribution of Convexal Subarachnoid Hemorrhage to Disease Progression in Cerebral Amyloid Angiopathy
Stroke 2015; first published on May 7 2015 as doi:10.1161/STROKEAHA.115.008778

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    2015-07-17 zsyan

    #脑淀粉样#

    0

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    2015-12-07 Luyuxie_17

    #血管病#

    0

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    2015-10-09 ms7524819409032184

    #病情#

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    2015-07-23 aliceclz

    #蛛网膜#

    0

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    2015-05-14 Smile2687

    #脑淀粉样血管病#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2046656, encodeId=c2f720466564a, content=<a href='/topic/show?id=9b708491280' target=_blank style='color:#2F92EE;'>#脑淀粉样#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84912, encryptionId=9b708491280, topicName=脑淀粉样)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dab8203, createdName=zsyan, createdTime=Fri Jul 17 20:05:00 CST 2015, time=2015-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1644433, encodeId=bc5b164443361, content=<a href='/topic/show?id=e3eb89e17fb' target=_blank style='color:#2F92EE;'>#血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89717, encryptionId=e3eb89e17fb, topicName=血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=64bb23195917, createdName=Luyuxie_17, createdTime=Mon Dec 07 20:05:00 CST 2015, time=2015-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1764971, encodeId=bc7f1e64971ef, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d1dc37824931, createdName=ms7524819409032184, createdTime=Fri Oct 09 21:05:00 CST 2015, time=2015-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1654407, encodeId=ce1d165440e10, content=<a href='/topic/show?id=5ab788e81d3' target=_blank style='color:#2F92EE;'>#蛛网膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88781, encryptionId=5ab788e81d3, topicName=蛛网膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=396c24497244, createdName=aliceclz, createdTime=Thu Jul 23 01:05:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628769, encodeId=164a1628e6938, content=<a href='/topic/show?id=1c748491616' target=_blank style='color:#2F92EE;'>#脑淀粉样血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84916, encryptionId=1c748491616, topicName=脑淀粉样血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac7921195890, createdName=Smile2687, createdTime=Thu May 14 02:05:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23368, encodeId=93c6233686c, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=160, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed May 13 20:58:00 CST 2015, time=2015-05-13, status=1, ipAttribution=)]
    2015-05-13 huaxipanxing

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