老年性蛛网膜下腔出血非典型症状30例分析

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CLINICAL DATSubjects came from 30 patients with senile subarachnoid hemrrhagetreated in our hospital from January 1999 to December 2001 in-cluding 12 males and 18 females aged 60-78(mean: 65) yearsold. 24 patients presented with onset in action, 6 patients at rest; 26cases presented with acute onset and 4 cases subacute onset. Acuteheadache as first symptom was in 13 cases; pain at neck, waist,sacral as first symptom in 7 cases. 3 patients searched medical ser-vice for headache within 1 week; 2 patients for severe pain of bothlimbs and unable to walk; 2 patients for headache and vomiting at 2week. 7 patients were once treated out of our hospital and sciaticawas diagnosed in 4 cases, cold in 3 cases. Pain at shoulder, back,upper limb in action occurred in 2 cases as first symptom, consciousdisturbance was the first symptom in 4 cases, grand mal of epilepsyas first symptom in 3 cases. 1 patient searched medical service forright head pain, auricle pain for 20 days. Stiff neck ( + ) appeared in25 patients at hospitalization and (-) in 5 patients. 24 patientspresented with positive Kig s sign. 21 patients were complicatedwith hypertension, 1 patient was complicated with peripheral facialparalysis and left hemihypoesthesia, 3 patients with transient hemi-paresis of both lower limhs, 2 cases with bilateral ptosis, 1 case withexotropia of bilateral eyeball, pupil dilation, 6 cases with consciousdisturbance. Auxilliary examination: (1) Skull CT scanning: Sub-arachnoid hemorrhage was found in 20 cases, no abnormality in 7cases and 3 cases didnt undergo CT scanning. (2) Examination ofspinal fluid: patients with positive CT findings didn t undergo lumbarpuncture, even hemic spinal fluid was found in 6 patients and yellowspinal fluid and shrinking red blood cell in 4 cases. Prognosis: Allcases were treated according to subarachnoid hemorrhage, 6 patientsdied and other 24 patients were cured after 6 - 8 weeks of treatment.
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