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

Mohammed Alhoobi; Fatma Abu-Qadous; Mohsin Khan; Ahmed Shaaban; Nissar Shaikh; Firas Hammadi; Raed Abu-Jarir; Walid Albanna; Ghaya Alrumaihi; Sirajelddin Belkhair; Arun Babu; Ali Ayyad

doi:10.4103/ajns.AJNS_315_19

Asian Journal of Neurosurgery, Table of Contents

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

Authors

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

¹Department 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

Abstract

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

Full Text

References

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