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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(01): 037-041
DOI: 10.1055/s-0040-1714302
Original Article

Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes

Ehsan Alimohammadi
1   Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
,
Paniz Ahadi
2   Clinical Research Development Center of Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
,
Ali Karbasforoushan
3   Department of Anesthesiology, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
,
Shamsoddin Rahmani
1   Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
,
Seyed Reza Bagheri
1   Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
,
Alireza Abdi
4   Nursing and Midwifery School, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
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Abstract

Background The present study aimed to investigate the risk factors, complications, and clinical outcomes of patients with nontraumatic, nonaneurysmal subarachnoid hemorrhage (NNSAH).

Methods We retrospectively evaluated 78 consecutive patients with NNSAH admitted to our center between April 2009 and April 2019. Patients were divided into two groups based on the distribution of blood in the CT scan, perimesencephalic subarachnoid hemorrhage ( PM-SAH) and nonperimesencephalic subarachnoid hemorrhage (nPM-SAH) groups. The outcome was assessed according to the Glasgow outcome scale (GOS). The demographic data and clinical records including age, sex, smoking history, hypertension, diabetes, history of anticoagulant medication, Glasgow coma score (GCS), Hunt–Hess (HH) grades, and in-hospital complications and clinical outcomes were retrospectively reviewed and compared between the two groups.

Results There were 45 patients (57.69%) in the PM-SAH group and 33 cases (42.30%) in the nPM-SAH group with the mean age of 53.98 ± 7.7 years. There were no significant differences between the two groups based on age, sex, smoking history, diabetes, hypertension, anticoagulation medication history, and HH grade at admission. The nPM-SAH group was significantly associated with a higher incidence of radiological and clinical vasospasm (p < 0.05). Moreover, the need for external ventricular drainage (EVD) placement because of the development of hydrocephalus was significantly higher in the nPM group (p < 0.05). Patients with PM-SAH had better clinical outcomes than those with nPM-SAH (p = 0.037).

Conclusions Our results showed that patients with nonaneurysmal subarachnoid hemorrhage (NSAH) had favorable clinical outcomes. The PM group had better clinical outcomes and lower complication rates in comparison with the nPM group. Repeated digital subtraction angiography (DSA) examinations are strongly recommended for patients with nPM-SAH.

Keywords

nontraumatic nonaneurysmal subarachnoid hemorrhage - digital subtraction angiography - perimesencephalic - nonperimesencephalic - Glasgow outcome scale


Publication History

Article published online:
27 November 2020

© 2020. Neurological Surgeons’ Society of India. 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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