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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Cureus
December 2024
Neurosurgery, Hospital de Braga, Braga, PRT.
Introduction A large majority of spontaneous subarachnoid hemorrhages (SAH) are attributed to aneurysm rupture, though the cause remains unknown in a notable percentage of cases. Non-aneurysmal SAH (naSAH) is generally thought to follow a more benign clinical course than aneurysmal SAH (aSAH); however, similar complications may occur, and poor outcomes are still possible. Given the limited research on naSAH, this study aims to characterize these patients and correlate clinical and radiographic findings with outcomes.
View Article and Find Full Text PDFFront Neurol
September 2022
Department of Neurosurgery, The First Hospital of Jilin University, Jilin, China.
Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a distinctive disease, representing SAH centered in perimesencephalic cisterns, with negative angiography findings. In recent years, the number of patients with PNSAH has increased significantly; however, the knowledge of PNSAH is insufficient. Therefore, we performed a review of the literature from a PubMed search and recounted our understanding of PNSAH.
View Article and Find Full Text PDFWorld J Clin Cases
May 2021
Department of Neurosurgery, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China.
Background: Spontaneous subarachnoid hemorrhage (SAH) is primarily caused by a ruptured intracranial aneurysm. Perimesencephalic nonaneurysmal SAH (PNSAH) accounts for approximately 5% of all spontaneous SAH. PNSAH displays favorable prognosis.
View Article and Find Full Text PDFWorld Neurosurg
September 2019
Department of Neurosurgery, Tosei General Hospital, Aichi, Japan.
Background: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a well-described subset of subarachnoid hemorrhage with an excellent prognosis in adults. However, its characteristics in the pediatric population have not yet been fully understood. We present a case of acute hydrocephalus requiring external ventricular drainage following pediatric PNSAH.
View Article and Find Full Text PDFWorld Neurosurg
July 2019
National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. Electronic address:
Background: Pretruncal nonaneurysmal subarachnoid hemorrhage (PNSAH) accounts for 15%-12% of all case of subarachnoid hemorrhage. Its precise etiology is not yet established. Multiple theories and risk factors have been investigated to address the possible cause of this type of hemorrhage including basilar tip dissecting aneurysms, high spinal arteriovenous fistula, venous stenosis/hypertension or venous bleeding.
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