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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 315-321
DOI: 10.4103/ajns.AJNS_315_19
Original Article

Ten years' experiences in the treatment of nonaneurysmal subarachnoid hemorrhage: A retrospective analysis of outcome parameters in a single-center study

Mohammed Alhoobi
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Fatma Abu-Qadous
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Mohsin Khan
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Ahmed Shaaban
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Nissar Shaikh
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Firas Hammadi
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Raed Abu-Jarir
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Walid Albanna
1   Department of Neurosurgery, RWTH, Aachen University, Aachen
,
Ghaya Alrumaihi
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Sirajelddin Belkhair
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Arun Babu
Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Ali Ayyad
Department of Neurosurgery, Hamad Medical Corporation, Doha
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Objectives: Subarachnoid hemorrhage (SAH) with negative angiographic findings has a heterogeneous nature with variations in clinical course and outcome as compared to the aneurysmal SAH. It makes up to 15% of the spontaneous SAH and is characterized by milder clinical presentation. The purpose of this study was the analyses of risk factors, clinical observations, radiologic characteristics, and outcome in patients with nonaneurysmal SAH (NA-SAH). Patients and Methods: In a retrospective design, 77 consecutive patients with NA-SAH were recruited from May 2008, to October 2018. All patients underwent conventional cerebral angiography. We stratified patients into two groups based on the distribution of blood on their CT scan into perimesencephalic (PM) and non-PM (NPM) SAH. We performed the Outcome using Glasgow Coma Scale (GCS) and modified Rankin scale (favorable mRS 0–2 vs. unfavorable mRS 3–6). Data were analyzed using IBM® SPSS® Statistics V22.0. Results: The mean age at presentation was 48.5 ± 8.4 years with male predominance (71.4%). About 76.7% of the patients had headache and vomiting, most of the patients (75.3%) presented with GCS 15 at initial clinical presentation (61.03%) had NPM versus (38.96%) with PM characters in computed tomography scans. Fourteen (17.9%) patients developed hydrocephalus and 12 (15.3%) needed external ventricular drain placement, while none of the patients needed permanent shunt placement. However, all patients had a favorable clinical and functional outcome at discharge and at late follow-up (up to 3 months). Conclusions: NA-SAH does not affect the short- and long-term prognosis. In our results, the pattern of bleeding affects the initial presentation, clinical course, and complications. The clinical and functional outcomes in the majority of our patients were comparable in both groups with good prognosis. Hypertension, smoking, and elevated venous pressure, such as a history of deep venous thrombosis and asthma might be considered as a risk factor.

Key-words:

Intracranial aneurysm - nonaneurysmal subarachnoid hemorrhage - non perimesencephalic - perimesencephalic - subarachnoid hemorrhage

Financial support and sponsorship

Nil.




Publication History

Received: 22 October 2019

Accepted: 16 January 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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