关键词: 蛛网膜下腔出血, 动脉瘤, 再出血, 危险因素

Abstract: Objective  To evaluate the clinical characteristics and risk factors of rebleeding after aneurysmal subarachnoid hemorrhage (aSAH), and provide guidances for the prevention of aSAH rebleeding. Methods  The clinical characteristics, imaging data, treatment and prognosis of 12 patients with rebleeding were analyzed. Results  The first symptoms of 12 patients with rebleeding were headache in 10 cases(83%),  disturbance of consciousness in 8 cases(67%),  with hunt Hess grade ⅢⅣ in 8 cases(67%) and improved Fisher grade ⅢⅣ in 10 cases (83%) on admission. A total of 7 patients (58%) had rebleeding within the first 24 hours after SAH.The mean arterial pressure after admission dramatically increased at rebleeding. The responsible aneurysms were located in the anterior cerebral artery (ACA) and anterior communicating artery (AComA) in 4 cases (33%),  and there were 5 patients (42%) of multiple aneurysms.All patients received aneurysms treatment. After SAH, acute hydrocephalus occurred in 9 cases (75%),  outdoor drainage in 6 cases (50%),  decompressive craniectomy in 1 case (8%),  and death in 5 cases (42%).Conclusion  Rebleeding after SAH has high mortality and poor prognosis.In order to reduce the disability and mortality rate,  intervention in the risk factors should be actively done.

Key words: subarachnoid hemorrhage, aneurysm, rebleeding, risk factor