表现为短暂性局灶性神经系统发作的脑凸面蛛网膜下腔出血1例并文献复习

doi:10.3969/j.issn.1004-583X.2026.03.010

临床荟萃 ›› 2026, Vol. 41 ›› Issue (3): 254-258.doi: 10.3969/j.issn.1004-583X.2026.03.010

表现为短暂性局灶性神经系统发作的脑凸面蛛网膜下腔出血1例并文献复习

杨凯琦¹^,²^,³, 唐亚赛²^,³^,⁴, 孙楠²^,³^,⁵, 肖伊宁²^,³, 吕佩源²^,³, 董艳红²^,³()

1.河北北方学院研究生院,河北张家口 075000
2.河北省人民医院神经内科,河北石家庄 050051
3.河北省脑网络与认知障碍重点实验室,河北石家庄 050051
4.河北医科大学研究生院,河北石家庄 050017
5.华北理工大学研究生学院,河北唐山 063210

收稿日期:2025-10-20 出版日期:2026-03-20 发布日期:2026-03-27
通讯作者: 董艳红,Email:d_yanhongniu@163.com
基金资助:
国家科技创新2030-“脑科学与类脑研究”重大项目——卒中后认知障碍诊断标准及临床转化预测研究(2021ZD0201807);河北省自然科学基金资助项目——丁苯酞对卒中后认知障碍的治疗机制及多模影像学研究(H2022307075)

Convexal subarachnoid hemorrhage presenting as transient focal neurological episodes: A case report and literature review

Yang Kaiqi¹^,²^,³, Tang Yasai²^,³^,⁴, Sun Nan²^,³^,⁵, XiaoYining ²^,³, Lv Peiyuan²^,³, Dong Yanhong²^,³()

1. Graduate School of Hebei North University, Zhangjiakou 075000, China
2. Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China
3. Hebei Province KEY Laboratory of Brain Network and Cognitive Impairment, Shijiazhuang 050051, China
4. Graduate School of Hebei Medical University, Shijiazhuang 050017, China
5. Graduate School of North China University of Science and Technology, Tangshan 063210, China

Received:2025-10-20 Online:2026-03-20 Published:2026-03-27

摘要/Abstract

摘要：

目的探讨表现为短暂性局灶性神经系统发作的脑凸面蛛网膜下腔出血的临床特征及影像特点。方法选取河北省人民医院神经内科表现为短暂性局灶性神经系统发作的脑凸面蛛网膜下腔出血患者1例,分析其临床及影像学特征,并复习相关文献。结果患者男性,60岁,主因“醒后发现言语不利伴左手不灵活2 h”入院。查头颅电子计算机断层扫描及磁共振成像示右顶额深脑梗死及右侧脑凸面蛛网膜下腔出血,住院治疗过程中间断出现口角向右歪斜伴舌头麻木、发硬,吐字不清,自觉咽部紧缩感、吞咽困难,上肢呈指尖至上臂游走性电流感,持续数分钟可自行缓解,给予奥卡西平可控制相关症状。结论脑凸面蛛网膜下腔出血患者出现类似脑缺血症状发作时,要考虑到短暂性局灶性神经系统发作的可能,提高诊断准确性。

关键词: 蛛网膜下腔出血, 短暂性局灶性神经系统发作, 临床特征

Abstract:

Objective To investigate the clinical and imaging characteristics of convexal subarachnoid hemorrhage presenting as transient focal neurological episodes. Methods We report one patient admitted to the Department of Neurology, Hebei General Hospital, who presented with transient focal neurological episodes and was found to have convexal subarachnoid hemorrhage. The patient's clinical presentation and imaging findings were analyzed, and the relevant literature was reviewed. Results The patient was a 60-year-old man who presented to hospital after awakening with speech impairment and left-hand clumsiness for 2 hours. Head CT and MRI demonstrated a deep right frontoparietal cerebral infarction and right-sided convexal subarachnoid hemorrhage. During hospitalization he intermittently developed rightward deviation of the oral commissure accompanied by numbness and stiffness of the tongue, slurred speech, subjective pharyngeal tightness and difficulty swallowing, and a migrating electric shock-like sensation in the upper limb from the fingertips to the upper arm. These episodes lasted several minutes and resolved spontaneously; symptoms were controlled with oxcarbazepine. Conclusion When patients with convexal subarachnoid hemorrhage develop brief, stroke-like neurological episodes, clinicians should consider transient focal neurological episodes in the differential diagnosis to improve diagnostic accuracy.

Key words: subarachnoid hemorrhage, transient focal neurological episodes, clinical features

中图分类号:

R743.35

杨凯琦, 唐亚赛, 孙楠, 肖伊宁, 吕佩源, 董艳红. 表现为短暂性局灶性神经系统发作的脑凸面蛛网膜下腔出血1例并文献复习[J]. 临床荟萃, 2026, 41(3): 254-258.

Yang Kaiqi, Tang Yasai, Sun Nan, XiaoYining , Lv Peiyuan, Dong Yanhong. Convexal subarachnoid hemorrhage presenting as transient focal neurological episodes: A case report and literature review[J]. Clinical Focus, 2026, 41(3): 254-258.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.03.010

https://www.lchc.cn/CN/Y2026/V41/I3/254

图/表 6

图1 头颅CT

Fig.1 Skull CT

图2 头颅DWI

Fig.2 Skull DWI

图3 头颅SWI

Fig.3 Skull SWI

图4 头颅MRI

Fig.4 Skull MRI

图5 头颅MRV

Fig.5 Skull MRV

图6 动态脑电图

Fig.6 Dynamic electroencephalogram

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表现为短暂性局灶性神经系统发作的脑凸面蛛网膜下腔出血1例并文献复习

Convexal subarachnoid hemorrhage presenting as transient focal neurological episodes: A case report and literature review

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