Perimesencephalic Subarachnoid Hemorrhage: Incidence, Risk Factors, and Outcome

Flaherty, Matthew L.; Haverbusch, Mary; Kissela, Brett M.; Kleindorfer, Dawn; Schneider, Alexander; Sekar, Padmini; Moomaw, Charles J.; Sauerbeck, Laura; Broderick, Joseph P.; Woo, Daniel

doi:10.1016/j.jstrokecerebrovasdis.2005.07.004

Cited by 121 publications

(87 citation statements)

References 17 publications

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“…Although this finding is controversial in the literature for ANSAH 8,22,40 , there are scarce data mentioning possible seasonal or circadian patterns in the particular case of ISAH 72 . Sex distribution favours men in our ISAH series, contrary to the female preponderance in ANSAH, in accordance with other series 15,33,61 . Median age of 55 years in ISAH and ANSAH groups is also comparable to other series, although there are small oscillations in different ISAH series depending on the proportion of patients with pmISAH which varies between 21 to 68%, because this type of ISAH is said to affect younger patients 15,61,67 .…”

Section: Discussionsupporting

confidence: 93%

“…Our ISAH series represents 19% of the total spontaneous SAH series, that is a percentage above the higher limit of the 5-15% usually cited in the literature 6,15,25,45,53,60,65,67,79 , but it has diminished compared to the 25-30% cited by previous Spanish series 33,40,46,48,57 , meaning that the diagnostic advances in our health system in the last years have favourably influenced aneurysmal detection as the cause of spontaneous SAH, in a way similar to other medical communities 21 . We haven't evidenced any seasonal or day of the week preference pattern for SAH occurrence either for the ANSAH nor the ISAH groups, similar to other studies 56 .…”

Section: Discussionmentioning

confidence: 72%

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Idiopathic subarachnoid hemorrhage: a multicentre series of 220 patients

et al. 2010

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SummaryBackground. The Spanish neurosurgical society created a multicentre data base on spontaneous SAH to analyze the real problematic of this disease in our country. This paper focuses on the group of patients with idiopathic SAH (ISAH).Methods. 16 participant hospitals collect their spontaneous SAH cases in a common data base shared in the internet through a secured web page, considering clinical, radiological, evolution and outcome variables. The 220 ISAH cases collected from November 2004 to November 2007 were statistically analyzed as a whole and divided into 3 subgroups depending on the CT blood pattern (aneurysmal, perimesencephalic, or normal).Results. Resultados. Los 220 pacientes con HSAI representan el 19% del total de 1.149 pacientes con HSA recogidos en la base de datos en el mismo periodo.El 46,8% de los casos de HSAI presentaron patrón de sangrado aneurismático en TC, hecho que se correlacionó con mayor edad, peor condición clínica al ingreso, mayor grado Fisher de sangrado, más frecuencia de hidrocefalia y peor evolución, comparados con los casos de HSAI con sangrado en TC del tipo perimesencefálico (42,7%) o con TC normal (10,4%).Una vez superada la fase aguda, e independientemente del tipo de sangrado inicial, la evolución de los pacientes con HSAI es globalmente buena y significativamente mejor que la de los pacientes con HSA aneurismática. La única variable con valor pronóstico en los casos de HSAI, tras realizar un análisis de Idiopathic subarachnoid hemorrhage: a multicentre series of 220 patients

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 72%

Idiopathic subarachnoid hemorrhage: a multicentre series of 220 patients

et al. 2010

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“…Lower complication risks, including vasospasm or hydrocephalus, have been reported especially for PM-SAH (47). The risk of re-bleeding is also reported to be minimal in PM-SAH (16,47). However, PM-SAH is not the only bleeding pattern in patients with NNSAH.…”

Section: █ Resultsmentioning

confidence: 99%

“…The 5 patients with positive spinal MRI or repeat DSA, with detected underlying causes underwent surgery and/or endovascular treatment. Of these 5 traumatic non-aneurysmal PM-SAH has been thoroughly investigated and defined as a benign form of SAH with relatively low morbidity and mortality rates (16,29,57). Lower complication risks, including vasospasm or hydrocephalus, have been reported especially for PM-SAH (47).…”

Section: █ Resultsmentioning

confidence: 99%

Clinical course of nontraumatic nonaneurysmal subarachnoid hemorrhage: a single institution experience over 10 years and review of the contemporary literature

Akçakaya

Aydöseli²,

Aras³

et al. 2016

Turkish Neurosurgery

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ABSTRACTof patients with non-traumatic subarachnoid hemorrhage, no underlying cause was detected on initial four to six vessel digital subtraction angiography (DSA) (13,21,31,48,52,54).Although the clinical course of non-traumatic non-aneurysmal subarachnoid hemorrhage (NNSAH) has been reported to be █ INTRODUCTION T he majority of non-traumatic subarachnoid hemorrhage (SAH) events are caused by the rupture of saccular aneurysms, which are associated with significant morbidity and mortality (16). However, in approximately 15% AIM: To report our experience with a relatively large series of patients with non-traumatic non-aneurysmal subarachnoid hemorrhage (NNSAH) to identify the prognosis associated with different bleeding patterns as well as a further diagnostic work-up to determine the underlying cause. MATERIAL and METHODS:Between January 2004 and December 2014, 81 patients with angiography-negative non-traumatic subarachnoid hemorrhage (SAH) were treated at our institution. Diagnosis was confirmed with a typical history of spontaneous SAH and cranial computed tomography (CT) scan or lumbar puncture (LP). The patients were grouped according to the bleeding pattern on the CT scan: Group 1: Perimesencephalic (PM) SAH (n=33, 40.7%); Group 2: Non-perimesencephalic (nPM) SAH (n=41, 50.6%); and Group 3: CT-negative NNSAH (n=7, 8.6%). The clinical course, hospitalization period, and complications were noted. All patients underwent an initial four-vessel digital subtraction angiography (DSA). Cranial magnetic resonance imaging (MRI), repeat DSA investigations and spinal MRI were performed in all patients. RESULTS:The mean hospital stays were 6.3, 14.7 and 10.1 days for patient groups 1, 2, and 3, respectively. The mortality rate was 1.2% (1 patient) in our series. Repeat DSA investigations were positive in two patients (2.5%), both from Group 2 (4.9%). Cranial MRI revealed 100% negative results. Spinal MRI revealed positive results in three patients from Group 2 (7.3%). CONCLUSION:We suggest our diagnostic work-up for patients with nPM-SAH, namely repeat DSA and spinal MRI, until an evidence-based guideline is established for the patient management.

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“…The verified causes of nontraumatic nonaneurysmal SAH were capillary telangiectasia, venous sinus stenosis, excessive strenuous exertion, benign perimesencephalic SAH, brain tumors, meningoencephalitis, Valsalva maneuver, coagulation disorders, severe arterial hypertension, and vasculitis 5,6,11,13,15,16) . Although the mechanism of its development is not clear, the arterial and/or venous hypertension during procedure, with resulting venous, capillary, or arteriolar bleeding, may proceed to SAH following PV.…”

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confidence: 99%

Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

Lim

Park

Kim

2009

J Korean Neurosurg Soc

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On rare occasions, percutaneous vertebroplasty (PV) may be associated with adverse spinal and extraspinal events. Subarachnoid hemorrhage (SAH) has not been reported complication following a PV. This is a report of two elderly women with spine compressions who developed idiopathic SAH after injecting polymethylmethacrylate into the thoracolumbar region transcutaneously. PV was performed as an usual manner on prone position under local anesthesia for these patients. During the interventions, two patients complained of a bursting nature of headache and their arterial blood pressure was jumped up. Computed tomography scans revealed symmetric SAH on the both hemispheres and moderate degree of hydrocephalus. Any intracranial vascular abnormalities for their SAH were not evident on modern neuroangiography modalities. One patient received a ventricular shunt surgery, but both fully recovered from the procedure-related SAH. The pathophysiologic mechanism that induce SAH will be discussed, with suggesting the manner that prevent and minimize this rare intracranial complication after PV.

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Perimesencephalic Subarachnoid Hemorrhage: Incidence, Risk Factors, and Outcome

Cited by 121 publications

References 17 publications

Idiopathic subarachnoid hemorrhage: a multicentre series of 220 patients

Idiopathic subarachnoid hemorrhage: a multicentre series of 220 patients

Clinical course of nontraumatic nonaneurysmal subarachnoid hemorrhage: a single institution experience over 10 years and review of the contemporary literature

Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

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