Non-aneurysmal non-traumatic subarachnoid hemorrhage: patient characteristics, clinical outcome and prognostic factors based on a single-center experience in 125 patients

作者：Konczalla Juergen^*; Platz Johannes; Schuss Patrick; Vatter Hartmut; Seifert Volker; Gueresir Erdem

来源：BMC Neurology, 2014, 14(1): 140.

DOI：10.1186/1471-2377-14-140

• Non-aneurysmal
• Aneurysm
• Perimesencephalic
• Non-perimesencephalic
• Prepontine
• Subarachnoid
• hemorrhage
• SAH

Background: Subarachnoid hemorrhage (SAH) is mainly caused by ruptured cerebral aneurysms but in up to 15% of patients with SAH no bleeding source could be identified. Our objective was to analyze patient characteristics, clinical outcome and prognostic factors in patients suffering from non-aneurysmal SAH. %26lt;br%26gt;Methods: From 1999 to 2009, data of 125 patients with non-aneurysmal SAH were prospectively entered into a database. All patients underwent repetitive cerebral angiography. Outcome was assessed according to the modified Rankin Scale (mRS) (mRS 0-2 favorable vs. 3-6 unfavorable). Also, patients were divided in two groups according to the distribution of blood in the CT scan (perimesencephalic and non-perimesencephalic SAH). %26lt;br%26gt;Results: 106 of the 125 patients were in good WFNS grade (I-III) at admission (85%). Overall, favorable outcome was achieved in 104 of 125 patients (83%). Favorable outcome was associated with younger age (P %26lt; 0.001), good admission status (P %26lt; 0.0001), and absence of hydrocephalus (P = 0.001). %26lt;br%26gt;73 of the 125 patients suffered from perimesencephalic SAH, most patients (90%) were in good grade at admission, and 64 achieved favorable outcome. %26lt;br%26gt;52 of the 125 patients suffered from non-perimesencephalic SAH and 40 were in good grade at admission. Also 40 patients achieved favorable outcome. %26lt;br%26gt;Conclusions: Patients suffering from non-aneurysmal SAH have better prognosis compared to aneurysm related SAH and poor admission status was the only independent predictor of unfavorable outcome in the multivariate analysis. Patients with a non-perimesencephalic SAH have an increased risk of a worse neurological outcome. These patients should be monitored attentively.

• 出版日期2014-7-1