AI Article Synopsis

  • The study investigates complications in two types of angiogram-negative spontaneous subarachnoid hemorrhages (PNSAH and NPNSAH), finding significant differences in outcomes.
  • Analysis included 34 patients, with results showing a low incidence of serious complications, but notable occurrences of transient hydrocephalus and cardiac issues.
  • The conclusion stresses the need for cardiac monitoring in patients following these types of SAH, as cardiac problems were more common than initially anticipated.

Article Abstract

Introduction: Subarachnoid haemorrhages (SAH) of unknown aetiology usually have a mild clinical presentation, favourable outcome and low complication rate.

Objective: The aim of this study was to analyse the complications in two forms of angiogram-negative spontaneous SAH: pretruncal (PNSAH) and nonpretruncal (NPNSAH).

Methods: The study group involved 18 patients with PNSAH and 16 patients with NPNSAH. CT scan was done within 72 hours from bleeding. All patients underwent four-vessel cerebral angiography. Repeat angiography was performed in five PNSAH and all NPNSAH patients.

Results: Twenty-nine patients were in grade I or II of the Hunt-Hess Scale (17 PNSAH and 12 NPNSAH). There was one case of rebleeding (NPNSAH patient), 10 cases of transient acute hydrocephalus (4 PNSAH and 6 NPNSAH). Cerebral vasospasm visualized by angiographies in two NPNSAH patients was local and mild, but was not found in PNSAH patients. Acute electrocardiography changes were found in 19 patients (significantly more frequently in NPNSAH than in PNSAH, 12 and 7 patients, respectively; p = 0.037).

Conclusion: Cardiac problems following these types of SAH are more frequent than expected, and therefore cardiac monitoring is necessary.

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