[Non-aneurysmal subarachnoid hemorrhage: 60 cases].

Introduction: Spontaneous subarachnoid hemorrhage (SAH) is idiopathic in 15% of cases. They represent a group whose characteristics are different from those with an aneurysmal etiology. We present a retrospective longterm follow up of 60 patients, analyzing symptomatology, complications and evolution and identify a subgroup of patients with a perimesencephalic pattern (PMP) in computed tomography (CT) for their excellent prognosis.

Methods: We collected information on 60 patients admitted to our center between 1992 and 2000 and divided them into three groups, according to neuroimage: 26 had a PMP, 28 showed an aneurysmal pattern (AP), and 6 patients had normal TC, with complete arteriographic study. Length of follow-up was 6-24 months.

Results: All of the 26 patients with SAH and PPM pattern were rated grade I-II on the Hunt-Hess scale. None of them had complications during hospital stay and at long term, 22 (84%) were asymptomatic, while 4 (16%) reported cephalea. Out of 28 patients with SAH and AP, 22 were rated Hunt-Hess Scale grade I and II (78%), 5 grade III (18%) and one patient was rated grade IV. Rebleeding caused death in one of them, and two required drainage for hydrocephalia. A total of 68% (19 patients) were asymptomatic and the others complained of cephalea.

Conclusions: We stress the good evolution of nonaneurysmal SAH at short and long term, especially those following a PMP with absence of complication.