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Neurology：急性凸面蛛网膜下腔出血：一个未被认识的CAA-ri表现

2019-08-12 zyx整理 神经科病例撷英拾粹

凸面蛛网膜下腔出血CAA-ri
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非创伤性急性凸面蛛网膜下腔出血（cSAH）是脑淀粉样血管病（CAA）的常见表现，但在CAA相关炎症（CAA-ri）患者中罕有报道。

非创伤性急性凸面蛛网膜下腔出血（cSAH）是脑淀粉样血管病（CAA）的常见表现，但在CAA相关炎症（CAA-ri）患者中罕有报道。

我们报道一例89岁女性的神经影像学表现，该患者有1个月的视幻觉，定向障碍和易激惹。脑MRI（图A-F）可见双侧半球播散性皮质表面含铁血黄素沉积，脑微出血和非对称性白质高信号。右侧顶叶还可见亚急性cSAH，伴蛛网膜下腔弥散受限和强化。

患者符合CAA-ri诊断标准，并接受静脉注射甲基强的松龙治疗，临床和影像学表现改善（图G）。



（图：磁敏度加权成像[SWI]可见凸面蛛网膜下腔出血[红箭，A]；可见蛛网膜下腔强化[B]和FLAIR上不对称白质高信号[C]；右侧顶叶弥散限制病灶[绿箭，D-E）；SWI上亦可见脑皮质微出血[黄箭，F]；皮质类固醇激素治疗后，右侧顶叶白质高信号消退[G]）

原始出处：Theodorou A1, Lachanis S2, Alexopoulos P2, et al. Teaching NeuroImages: Acute convexity subarachnoid hemorrhage: An underrecognized presentation of CAA-ri. Neurology. 2019 Jul 30;

评论区 (4)
#插入话题
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    2019-10-28 aliceclz

    #蛛网膜#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1654483, encodeId=3fe416544832d, 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=233, 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=Mon Oct 28 10:35:00 CST 2019, time=2019-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005555, encodeId=f3702005555c3, content=<a href='/topic/show?id=932b39438c' target=_blank style='color:#2F92EE;'>#CAA-ri#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=224, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3943, encryptionId=932b39438c, topicName=CAA-ri)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5712500001, createdName=晓辰, createdTime=Sat Jan 18 12:35:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000843, encodeId=7744200084353, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Mar 09 07:35:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534003, encodeId=d56b153400395, content=<a href='/topic/show?id=238c3942eb' target=_blank style='color:#2F92EE;'>#CAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=232, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3942, encryptionId=238c3942eb, topicName=CAA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad6312510186, createdName=huangdf, createdTime=Wed Aug 14 13:35:00 CST 2019, time=2019-08-14, status=1, ipAttribution=)]
    2020-01-18 晓辰

    #CAA-ri#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1654483, encodeId=3fe416544832d, 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=233, 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=Mon Oct 28 10:35:00 CST 2019, time=2019-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005555, encodeId=f3702005555c3, content=<a href='/topic/show?id=932b39438c' target=_blank style='color:#2F92EE;'>#CAA-ri#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=224, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3943, encryptionId=932b39438c, topicName=CAA-ri)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5712500001, createdName=晓辰, createdTime=Sat Jan 18 12:35:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000843, encodeId=7744200084353, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Mar 09 07:35:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534003, encodeId=d56b153400395, content=<a href='/topic/show?id=238c3942eb' target=_blank style='color:#2F92EE;'>#CAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=232, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3942, encryptionId=238c3942eb, topicName=CAA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad6312510186, createdName=huangdf, createdTime=Wed Aug 14 13:35:00 CST 2019, time=2019-08-14, status=1, ipAttribution=)]
    2020-03-09 yinhl1978

    #Neurol#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1654483, encodeId=3fe416544832d, 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=233, 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=Mon Oct 28 10:35:00 CST 2019, time=2019-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005555, encodeId=f3702005555c3, content=<a href='/topic/show?id=932b39438c' target=_blank style='color:#2F92EE;'>#CAA-ri#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=224, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3943, encryptionId=932b39438c, topicName=CAA-ri)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5712500001, createdName=晓辰, createdTime=Sat Jan 18 12:35:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000843, encodeId=7744200084353, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Mar 09 07:35:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534003, encodeId=d56b153400395, content=<a href='/topic/show?id=238c3942eb' target=_blank style='color:#2F92EE;'>#CAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=232, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3942, encryptionId=238c3942eb, topicName=CAA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad6312510186, createdName=huangdf, createdTime=Wed Aug 14 13:35:00 CST 2019, time=2019-08-14, status=1, ipAttribution=)]
    2019-08-14 huangdf

    #CAA#

    0