张永力
【关键词】脑动脉瘤;诊断;诊断动脉瘤;检查;CT;
Aneurysms are more common type of nervous system diseases, attack is a sudden, it is also
one of clinical common emergency, in case of an aneurysm, conventional diagnosis is
CTJIANCHA, CT has a high diagnostic rate, for clinical early diagnosis and treatment and
evaluating prognosis of plays an important role.
本图片来源:三博脑血管疾病网:http://www.naoxueguanjb.com
动脉瘤是神经系统较为常见的一类疾病,发作呈突发性,也是临床上常见的急诊之一,一旦发生动脉瘤,
常规的诊断是 CTJIANCHA ,CT 具有极高诊断率,为临床的早期诊治及评估预后有着重要的作用。
高级别颅内动静脉畸形的治疗北京三博脑科医院张永力医生治疗案例;
Aneurysm bleeding often appear as subarachnoid hemorrhage, CT as a routine diagnostic
methods, performance and the bleeding, bleeding time and cerebrospinal fluid mixing degree
of dilution factor. According to CT signs can be divided into high density shadow of the
pool, sulcus of the brain subarachnoid hemorrhage, and don't show high density shadow, show
only the longitudinal crack on the brain, awning widened slightly and the disappearance of
the pool, sulcus of the brain subarachnoid hemorrhage.
CT in the diagnosis of aneurysm sensitivity of 90% to 90% within 24 hours, 3 days
sensitivity was 80%, l weeks was 50%. Visible as the extension of bleeding time, decrease
its sensitivity. Through CT examination can discover the location of the rupture of aneurysm;
Can also show the essence of local pork bleeding or subdural hemorrhage, cerebral ventricle
enlarge, larger and thrombosis of the aneurysm and vasospasm caused by cerebral infarction
动脉瘤出血常出现为蛛网膜下腔出血,CT 作为常规的诊断方法,可
表
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现与出血量、出血时间及脑脊液混
合稀释程度等因素。根据 CT 征象可分为显示脑池、沟高密度影的蛛网膜下腔出血和不显示高密度影,仅
显示大脑纵裂、天幕稍增宽及脑池、沟消失的蛛网膜下腔出血。
CT 对动脉瘤的诊断敏感性在 24 小时内为 90% -95%,3 天敏感性为 80%,l 周为 50%。可见随着出血时间的
延长,敏感性逐渐下降。通过 CT 检查可以发现破裂的动脉瘤的位置;还可以显示局部腩实质的出血或硬膜
下出血、脑室扩大、较大而有血栓形成的动脉瘤和血管痉挛引起的脑梗死。通过 CT 动态检查还有助于了
解出血的吸嘘情况,有无再出血等。CT 还可以显示脑积水。这些结果在临床蛛网膜下腔治疗中对治疗有
指导意义。
张永力,北京三博脑科医院(首都医科大学第十一临床医学院)神经外科 北京香山一棵松
50 号 100093