上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (8): 1184-.doi: 10.3969/j.issn.1674-8115.2017.08.027

• 病例报告 • 上一篇    

蛛网膜下腔出血动脉瘤栓塞术后合并吉兰-巴雷综合征1例报道

王长明，张金菊，刘海军，魏志杰，张丽   

  1. 遵义医学院附属第一医院神经内科，遵义 563003
  • 出版日期:2017-08-28 发布日期:2017-09-28
  • 通讯作者: 王长明（1975—），男，副主任医师，硕士；电子信箱：wangchangming@163.com
  • 作者简介:王长明（1975—），男，副主任医师，硕士；电子信箱：wangchangming@163.com

A case report of Guillain-Barré syndrome associated with subarachnoid hemorrhagic aneurysm embolization

WANG Chang-ming, ZHANG Jin-ju, LIU Hai-jun, WEI Zhi-jie, ZHANG Li   

  1. Department of Neurology, First Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
  • Online:2017-08-28 Published:2017-09-28

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摘要：  1 例 47 岁女性患者，突发剧烈头痛2 d。经头颅CT、数字减影血管造影（DSA）检查后诊断为自发性蛛网膜下腔出血 （SAH，hunt-Hess 分级Ⅱ级） - 前交通动脉瘤破裂。行血管内介入动脉瘤栓塞治疗，术后 5 ｄ出现渐进性四肢无力。查体见双上肢肌 力 2 级，双下肢肌力 1 级。四肢肌张力减低，腱反射消失，双上肢腕关节以下痛觉减退，双踝关节以下痛觉减退。神经电生理及腰椎 穿刺查脑脊液等各项检查后诊断为 SAH 动脉瘤栓塞术后合并吉兰 - 巴雷综合征。

关键词:  蛛网膜下腔出血, 动脉瘤, 吉兰 - 巴雷综合征

Abstract:

 A case of a 47-year-old female patient who had a severe headache for 2 days was reported. Spontaneous subarachnoid hemorrhage (SAH, huntHess classification Ⅱ level)-anterior communicating aneurysm rupture was diagnosed by brain CT and digital subtraction angiography (DSA) examination. Intravascular interventional aneurysm embolization was performed, and the patient appeared progressive limb weakness 5 days after operation. Physical examination revealed grade Ⅱ upper limb muscle strength and grade Ⅰ lower limb muscle strength. The muscle tone of the extremities was decreased, and the tendon reflex disappeared. The pinprick pain was decreased below the double wrist joints and the ankle joints. After neuroelectrophysiology test and cerebrospinal fluid assay, the patient was diagnosed as Guillain-Barré syndrome associated with subarachnoid hemorrhagic aneurysm embolization.

Key words: subarachnoid hemorrhage, aneurysm, Guillain-Barré, syndrome