颅内多发性动脉瘤伴多发血管畸形1例
Chinese Journal of Neurosurgical Disease Research(2012)
Abstract
患者,女,49岁,因“突发头痛1d”于2011年5月6日人院.1d前患者无明显诱因出现头痛,为炸裂样剧痛、伴有头晕,恶心,无呕吐,无昏迷,无肢体抽搐,无大小便失禁,行头颅CT检查示蛛网膜下腔出血.入院体检:患者神志清楚,精神差,体温:36.8℃,呼吸:20次/min,脉搏:58次/min,血压:144/71 mmHg,双侧瞳孔等大等圆,对光反射灵敏,直径D=2.5mm,颈项强直.双肺呼吸平稳,呼吸音清晰,活动度对称,未闻及干湿罗音,心音有力,律整齐,各瓣膜听诊区未闻及病理性杂音.腹平软,肝脾肋下未及,无移动性浊音,肠鸣音正常.脊柱生理弯曲正常,四肢活动自如,生理反射存在,病理反射未引出.入院行脑血管造影检查可见左颈内动脉眼段动脉瘤及前交通动脉瘤,附见先天性右位主动脉,左颈总动脉缺失,一侧颈总动脉供应双侧大脑(图1~4).
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