CVS诊断标准:i症状体征方面:i①SAH症状好转后出现新的症状或加重;②意识障碍呈波动性或进行性加重,l由清醒至嗜睡或昏迷;③出现神经功能缺损症状、i刺激症状和局灶性定位体征,l如偏瘫、i偏身感觉障碍和癫癎等;④前3项均在24h内缓解;⑤除外再出血;⑥CT除外DCI。TCD诊断CVS标准:i①血流速度明显加快,lMCA1Vm1l20~140cm/s为轻度痉挛,ll40~200cm/s为中度痉挛,l>200cm/s为重度痉挛。但应注意当CVS所致血管狭窄达原管径的80%以上时,l血流速度反而减慢。SAH后颅底动脉和其远端小动脉痉挛的TCD表现不同,l前者表现为Vm与脉动指数(PI)增高,l而后者表现为PI增高伴Vm降低。②血流频谱紊乱或回声频谱。③有杂音。④受检Vm逐日大幅递增,l每日递增超过l5cm/s。
引自
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