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International Journal of Neurology and Neurosurgery

Volume  10, Issue 3, Jul-Sep 2018, Pages 260-263
 

Original Article

Outcome Predictors of Non-Aneurysmal Spontaneous Subarachnoid Hemorrhage: A Retrospective Analysis in A Tertiary Care Center

Raghavendra Nayak1, Bhagwati Salgotra2, Nitin Jagdhane3

1Associate Professor, Department of Neurosurgery, Kasturba Medical College (KMC), Udupi, Manipal, Karnataka 576104, India. 2Associate Professor, Department of Neurosurgery, SBKS Medical College, Vadodara, Gujarat 391760, India. 3Senior Consultant, Neurosurgeon, Dr. L.H. Hiranandani Hospital, Powai, Mumbai, Maharashtra 400076, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10318.18

Abstract

  Background: Non aneurysmal subarachnoid hemorrhage accounts for about 15% of all spontaneous subarachnoid hemorrhages. Literature has less data of outcome of these patients. To analyze factors affecting the outcome of patients with angio­negative subarachnoid hemorrhage (SAH). Methods: Retrospective analysis of data of patients with angio­negative SAH admitted in a tertiary care hospital from 2013 to 2018. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months. Results: Total 44 patients (18 Males, 16 Females with a ratio of 1.1:1) were included in the study. The mean age of presentation was 48.9±11.8. On imaging, 24 (55.5%) patients had perimesencephalic SAH (PM­SAH) and 20 (45.5%) had non­perimesencephalic SAH (NPM­SAH). Among 44 patients, 37 (84 %) of were clinically in good conditions (WFNS I/III) at presentation. 91% (22 out of 24) of patients with PMSAH had a good clinical status compared to the patients with NPM­SAH (75%) which clinically was not significant (p=0.13). 19 (43%) Patients were having arterial hypertension (Systolic BP >140). 10 (23%) patients were on anticoagulation medications. Overall, 12 (27%) patients developed an early hydrocephalus and required an EVD. Good outcome was seen in 35 (83%) patients. On multivariate analysis early hydrocephalus and poor admission clinical status emerged as an independent factors for the poor outcomes [Table 2]. Conclusions: Early onset hydrocephalus and poor admission WFNS grade are the independent predictor of poor outcomes. Permanent shunt dependency is significantly higher in patients with NPM­SAH. Patients with a NPM­SAH special attention as they have relatively poor neurological course compared to the patients with PM­SAH.

Keywords: Spontaneous Subarachnoid Hemorrhage; Perimesenchalic; Aneurysm; Angionegative.


Corresponding Author : Bhagwati Salgotra, Associate Professor, Department of Neurosurgey, SBKS Medical College, Vadodara, Gujarat 391760, India