AJNR病例 | 假性蛛网膜下腔出血
病史:患者因昏迷入住于重症监护室,目前已苏醒。
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.
图1-3:横断位非增强 CT 扫描显示大脑弥散性低密度,灰白质分界不清,脑沟模糊,蛛网膜下腔及脑池密度增高。
诊断:假性蛛网膜下腔出血(Pseudo-Subarachnoid Hemorrhage)
通常继发于复苏或严重头部创伤引起的脑水肿之后;
预后较差;
病理生理学:大脑水肿引起的弥散性低密度影,线状高密度表明为充盈的静脉结构,在非增强 CT 扫描上通常表现为相对的高信号。
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
诊断要点:
弥散性低密度影;
灰白质分界不清;
脑沟模糊,蛛网膜下腔及脑池密度增高(CT衰减系数25–35 HU)。
鉴别诊断:蛛网膜下腔出血;软脑膜疾病。
假性蛛网膜下腔出血病例图片:
图片来源:www.ajnr.org
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