초기혈관조영술상 음성의 소견을 보인 지구막하출혈에 대한 연구
Subarachnoid Hemorrhage with Negative Initial Angiography
소속 상세정보
최현배/Hyun Bae Choi
임동준/박윤관/정흉섭/이기환/이훈갑/Dong Jun Lim/Youn Kwan Park/Heung Seob Chung/Ki Whan Lee/Hoon Kap Lee
KMID : 0359819980270010037
Abstract
결론
최근 7년간 내원한 자발성 지주막하출혈환자에서 1차 뇌혈관조영술상 음성의 소견을 보였
던 71례의 임상분석을 통하여 다음과 같은 결론을 얻었다
1) 2차 뇌혈관조영술에서 45.1%의 높은 양성소견을 보여 반복적인 뇌혈관조영술의 시행가
치가 명백하였다
2) 내원당시 Hunt-Hess 임상등급이 높았던 경우 2차 뇌혈관조영술에서의 양성을 예측할 반
한 신뢰도가 높은 인자로 나타났으며 1차 뇌혈관조영술상 뇌혈관연축이 있는 경우도 2차 뇌
혈관조영술에서의 양성의 확률이 높은 것으로 사료되었다.
3) 2차의 뇌혈관조영술의 시기는 뇌동맥류의 발견율에 영향을 미치는 인자로 사료되며 증상
발현 3주 이후가 적절할 것으로 사료되었다
#초록#
In 614 of 793 cases with subarachnoid hemorrhage(SAH), four vessel cerebral
angiography was performed to investigate the source of the hemorrhage. The first four
vessel study revealed 501 cases of ruptured cerebral aneurysms ; during initial
pan-angiography studies. 113 SAH patients did not show vascular lesions. Thirty two of
71 patients(45.1%) showed aneurysms on repeat angiography ; fifteen of them had
aneurysms in the anterior communication artery. Among patients whose Hunt Hess
grade on admission was poor(Ⅲ-Ⅳ), the possibility of revealing aneurysm during
repeated angiography was higher than in those whose grade was good was good(Ⅰ-
Ⅱ)(p<0.05, Fisher exact test). On repeat angiography, the age, sex and CT grade of
patients with aneurysm were indistinguishable from those of patients without ; even in
those who on initial angiography showed angiographic vasospasm, the chance of
revealing an aneurysm was the same as in those without spasm. We concluded that
repeated angiography, especially after 3 weeks of ictus, was valuable for the detection of
an initially underfined aneurysm.
키워드
Negative angiography; Repeated angiography; Subarachnoid hemorrhage; Unknown etiology;
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