打印 诊断为了诊断蛛网膜下腔出血,医务人员可能建议: CT 扫描。这种影像学检查可以检测脑出血。虽然在操作正确的情况下 CT 扫描是一项非常有效的检查,但如果您的红细胞计数较低(贫血),并且在出血时只有少量失血,扫描可能无法发现出血。医生可能注射造影剂,以更详细地查看您的血管(CT 血管造影)。 MRI。这种影像学检查也可以检测脑出血。医务人员可能将染色剂注射到血管中,以更详细地查看动脉和静脉(MR 血管造影),并突出显示血流。在 CT 扫描未显示出蛛网膜下腔出血迹象的极少数情况下,这种方法可能显示出相关迹象。 脑血管造影。医务人员将一根细长管(导管)插入动脉并穿行至大脑。然后,将染色剂注入脑部血管,以让它们显示在 X 线影像中。医务人员可能建议进行脑血管造影,以获得更详细的图像。如果怀疑是蛛网膜下腔出血,但原因不明确或其他影像学检查未检出,他们也可能建议进行该项检查。如果第一次未显示出动脉瘤,但医务人员认为很可能存在动脉瘤,您可能需要进行第二次脑血管造影。 在一些动脉瘤性蛛网膜下腔出血病例中,初始影像学检查可能无法发现出血。如果首次 CT 扫描检查未显示出血,医生可能建议进行腰椎穿刺。腰椎穿刺是将针头插入下背部,以抽取少量脑脊液(大脑和脊髓周围的液体)。然后检查这些液体中是否有血液,有则可能意味着您存在蛛网膜下腔出血。 Our caring team of Mayo Clinic experts can help you with your 蛛网膜下腔出血-related health concerns 治疗治疗的重点是稳定病情,治疗动脉瘤(如有),并预防并发症。 医务人员会检查您的呼吸、血压和血流。 如果出血是由脑动脉瘤破裂引起,医务人员可能会建议: 外科手术。外科医生在头皮上开一个切口,并找到脑动脉瘤。在动脉瘤上放置金属夹,以阻止血液流向动脉瘤。 血管内栓塞术。外科医生将导管插入一根动脉中,然后将其引导至大脑中。引导可脱铂丝弹簧圈穿过导管,将其置于动脉瘤中。弹簧圈会填塞动脉瘤,减少流入动脉瘤囊的血液并使血液凝结。已经开发出了各种类型的弹簧圈用于治疗各种动脉瘤。 其他血管内治疗。某些动脉瘤可采用血管内栓塞治疗,这种治疗方法使用较新的技术,例如支架辅助或球囊辅助的弹簧圈或血流导向装置。 由于您可能会再次出血,大脑血流不畅,血液中的钠等盐含量偏低,脑内积液过多,或者血糖偏高或偏低,因此务必要预防并发症。药物尼莫地平(Nymalize)已被证明可以减少蛛网膜下腔出血后的脑部循环问题。 脑血管迟发性痉挛是动脉瘤性蛛网膜下腔出血后常见的一种并发症。如果血流量因此下降到一定水平以下,就会导致卒中。当发生脑血管迟发性痉挛时,可以静脉注射药物提高血压或使用药物扩张大脑血管,以防止卒中。 另一种常见的并发症是脑积水,也就是液体在脑腔隙中的积聚。脑积水可以通过在头部(脑室造口导管)或下背部(腰椎引流管)插入引流管来治疗。 有时,需要重复这些医疗程序。您需要到医务人员那里定期复诊,以观察是否有任何变化。您还可能需要物理、作业和言语治疗。 临床试验 探索 Mayo Clinic 的研究 测试新的治疗、干预与检查方法,旨在预防、检测、治疗或控制这种疾病。 准备您的预约A subarachnoid hemorrhage is a medical emergency, so it is likely to be treated in the emergency department. Doctors who specialize in the brain and nervous system may be involved in your care. These specialists may include neurologists, neurosurgeons and neuroradiologists. What you can doTo make the most of your time with your healthcare team, be ready with the following information. Make a list of: Your symptoms, including any that seem unrelated to the reason for seeking medical care. Key personal information, including major stresses, recent life changes and family medical history. All medicines, vitamins or other supplements you take, including the doses. Questions to ask your healthcare team. For subarachnoid hemorrhage, some basic questions to ask your healthcare professional include: What's likely causing my symptoms? Other than the most likely cause, what are other possible causes for my symptoms? What tests do I need? Is my condition likely short-term or long-lasting? What's the best course of action? What are the alternatives to the primary approach you're suggesting? I have these other health conditions. How can I best manage them together? Are there restrictions I need to follow? Should I see a specialist? Are there brochures or other printed material I can have? What websites do you recommend? Don't hesitate to ask other questions. What to expect from your doctorYour healthcare professional is likely to ask you several questions, such as: When did your symptoms begin? Have your symptoms been constant, or do they come and go? How serious are your symptoms? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? 来自妙佑医疗国际员工 在 Mayo Clinic 治疗 申请预约 症状与病因医生与科室 Aug. 31, 2022 打印 显示参考文献 Winn HR. Perioperative management of subarachnoid hemorrhage. In: Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, Pa.: Elsevier; 2023. https://www.clinicalkey.com. Accessed May 6, 2022. Connolly ES, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: A guideline for the healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012; doi: 10.1161/str.0b013e3182587839 Siddiq F. Nonaneurysmal subarachnoid hemorrhage. https://www.uptodate.com/contents/search. Accessed May 6, 2022. Ferri FF. Subarachnoid hemorrhage. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed May 6, 2022. Singer RJ, et al. Aneurysmal subarachnoid hemorrhage: Epidemiology, risk factors, and pathogenesis. https://www.uptodate.com/contents/search. Accessed May 6, 2022. Dubosh NM, et al. Diagnosis and initial emergency department management of subarachnoid hemorrhage. Emergency Medical Clinics of North America. 2021; doi: 10.1016/j.emc.2020.09.005 Chakraborty T, et al. CT-negative subarachnoid hemorrhage in the first six hours. Journal of Stroke and Cerebrovascular Diseases. 2020; doi: 10.1016/j.jstrokecerebrovasdis.2020.105300 Singer RJ, et al. Clinical manifestations and diagnosis of aneurysmal subarachnoid hemorrhage. https://www.uptodate.com/contents/search. Accessed May 6, 2022 Torregrossa F, et al. Therapeutic approaches for cerebrovascular dysfunction after aneurysmal subarachnoid hemorrhage: An update and future perspectives. World Neurosurgery. 2022; doi: 10.1016/j.wneu.2021.11.096 Singer RJ, et al. Treatment of aneurysmal subarachnoid hemorrhage. https://www.uptodate.com/contents/search. Accessed May 6, 2022. Tawk, RG, et al. Diagnosis and treatment of unruptured intracranial aneurysms and aneurysmal subarachnoid hemorrhage. Mayo Clinic Proceedings. 2021; doi: 10.1016/j.mayocp.2021.01.005 Daroff RB, et al. Intracranial aneurysms and subarachnoid hemorrhage. In: Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed May 6, 2022. Singer RJ, et al. Treatment of cerebral aneurysms. https://www.uptodate.com/contents/search. Accessed July 5, 2022. Youssef PP, et al. Woven endobridge(WEB) device in the treatment of ruptured aneurysms. Journal of Interventional Surgery. 2021; doi: 10.1136/neurintsurg-2020-016405 Gupta R, et al. Primary results of the Vesalio NeVa VS for the treatment of symptomatic cerebral vasospasm following aneurysm subarachnoid hemorrhage (vital) study. Journal of Interventional Surgery.2021; doi: 10.1136/neurintsurg.2021.017859 Guerra H, et al. The first CT in a subarachnoid hemorrhage: A picture tells a story. Practical Neurology. 2017; doi: 10.1136/practneurol-207-001639 Kramer CL, et al. Refining the association of fever with functional outcome in aneurysmal subarachnoid hemorrhage. Neurocritical Care. 2017; doi: 10.1007/s12028-0160281-7 Rinaldo L, et al. Transfer to high-volume centers associated with reduced mortality after endovascular treatment of acute stroke. Stroke. 2017; doi: 10.1161/strokeaha.116360 Pegoli M, et al. Predictors of excellent functional outcome in aneurysmal subarachnoid hemorrhage. Journal of Neurosurgery. 2015; doi: 10.3171/2014.10jns14290 Nguyen HT. Allscripts EPSi. Mayo Clinic. April 22, 2022. Rabinstein AA (expert opinion). Mayo Clinic. July 1, 2022. 相关 产品与服务 书籍:《妙佑医疗国际家庭健康手册》第 5 版 简报:妙佑医疗国际卫生来信 — 数字版 显示更多来自妙佑医疗国际的产品和服务 蛛网膜下腔出血症状与病因诊断与治疗医生与科室在 Mayo Clinic 治疗 Advertisement 妙佑医疗国际不为任何公司或产品背书。广告收入为我们的非营利使命提供支持。 广告与赞助政策 政策 机会 广告选择 妙佑医疗国际出版社 浏览妙佑医疗国际出版社提供的畅销书以及书籍和简报的特别优惠。 NEW: Listen to Health Matters Podcast - 妙佑医疗国际出版社NEW: Listen to Health Matters Podcast《妙佑医疗国际论失禁》(Mayo Clinic on Incontinence) - 妙佑医疗国际出版社《妙佑医疗国际论失禁》(Mayo Clinic on Incontinence)《糖尿病基本知识》 - 妙佑医疗国际出版社《糖尿病基本知识》妙佑医疗国际论平衡和听觉 - 妙佑医疗国际出版社妙佑医疗国际论平衡和听觉妙佑医疗国际免费饮食方案评估 - 妙佑医疗国际出版社妙佑医疗国际免费饮食方案评估妙佑医疗国际健康通讯 — 免费书籍 - 妙佑医疗国际出版社妙佑医疗国际健康通讯 — 免费书籍 CON-20313611 患者护理和健康信息 疾病与状况 蛛网膜下腔出血