假性蛛網膜下腔出血
感謝HW ZHAO老師的整理
病史:患者因昏迷入住於重症監護室,目前已甦醒。
Axial noncontrast CT scans demonstrate diffuse cerebral hypodensity, loss of gray-white matter differentiation, effacement of sulci, and increased attenuation within the subarachnoid spaces and the cisterns.
圖1-3:橫斷位非增強 CT 掃描顯示大腦彌散性低密度,灰白質分界不清,腦溝模糊,蛛網膜下腔及腦池密度增高。
診斷:假性蛛網膜下腔出血(Pseudo-Subarachnoid Hemorrhage)
通常繼發於復甦或嚴重頭部創傷引起的腦水腫之後;
預後較差;
病理生理學:大腦水腫引起的彌散性低密度影,線狀高密度表明爲充盈的靜脈結構,在非增強 CT 掃描上通常表現爲相對的高信號。
Key Diagnostic Features:
Diffuse hypodensity
Loss of gray-white matter differentiation
Effacement of sulci and appearance of increased attenuation (attenuation coefficients 25–35 HU) within cisterns and subarachnoid spaces
診斷要點:
彌散性低密度影;
灰白質分界不清;
腦溝模糊,蛛網膜下腔及腦池密度增高(CT衰減係數25–35 HU)。
鑑別診斷:蛛網膜下腔出血;軟腦膜疾病。
假性蛛網膜下腔出血病例圖片:
圖片來源:www.ajnr.org
圖片來源:www.neurology.org