Spontaneous angiogram-negative subarachnoid hemorrhage: a retrospective single center cohort study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-12-01

AUTHORS

Alexander Achrén, Rahul Raj, Jari Siironen, Aki Laakso, Johan Marjamaa

ABSTRACT

BackgroundSpontaneous angiogram-negative subarachnoid hemorrhage (SAH) is considered a benign illness with little of the aneurysmal SAH-related complications. We describe the clinical course, SAH-related complications, and outcome of patients with angiogram-negative SAH.MethodsWe retrospectively reviewed all adult patients admitted to a neurosurgical intensive care unit during 2004–2018 due to spontaneous angiogram-negative SAH. Our primary outcome was a dichotomized Glasgow Outcome Scale (GOS) at 3 months. We assessed factors that associated with outcome using multivariable logistic regression analysis.ResultsOf the 108 patients included, 84% had a favorable outcome (GOS 4–5), and mortality was 5% within 1 year. The median age was 58 years, 51% were female, and 93% had a low-grade SAH (World Federation of Neurosurgical Societies grading I–III). The median number of angiograms performed per patient was two. Thirty percent of patients showed radiological signs of acute hydrocephalus, 28% were acutely treated with an external ventricular drain, 13% received active vasospasm treatment and 17% received a permanent shunt. In the multivariable logistic regression model, only acute hydrocephalus associated with unfavorable outcome (odds ratio = 4.05, 95% confidence interval = 1.05–15.73). Two patients had a new bleeding episode.ConclusionSAH-related complications such as hydrocephalus and vasospasm are common after angiogram-negative SAH. Still, most patients had a favorable outcome. Only acute hydrocephalus was associated with unfavorable outcome. The high rate of SAH-related complications highlights the need for neurosurgical care in these patients. More... »

PAGES

129-140

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00701-021-05069-7

DOI

http://dx.doi.org/10.1007/s00701-021-05069-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1143538859

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34853936


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