Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes

Background The present study aimed to investigate the risk factors, complications, and clinical outcomes of patients with nontraumatic, nonaneurysmal subarachnoid hemorrhage (NNSAH). Methods We retrospectively evaluated 78 consecutive patients with NNSAH admitted to our center between April 2009 an...

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Main Authors: Ehsan Alimohammadi, Paniz Ahadi, Ali Karbasforoushan, Shamsoddin Rahmani, Seyed Reza Bagheri, Alireza Abdi
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-03-01
Series:Indian Journal of Neurosurgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1714302
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author Ehsan Alimohammadi
Paniz Ahadi
Ali Karbasforoushan
Shamsoddin Rahmani
Seyed Reza Bagheri
Alireza Abdi
author_facet Ehsan Alimohammadi
Paniz Ahadi
Ali Karbasforoushan
Shamsoddin Rahmani
Seyed Reza Bagheri
Alireza Abdi
author_sort Ehsan Alimohammadi
collection DOAJ
description Background The present study aimed to investigate the risk factors, complications, and clinical outcomes of patients with nontraumatic, nonaneurysmal subarachnoid hemorrhage (NNSAH). Methods We retrospectively evaluated 78 consecutive patients with NNSAH admitted to our center between April 2009 and April 2019. Patients were divided into two groups based on the distribution of blood in the CT scan, perimesencephalic subarachnoid hemorrhage ( PM-SAH) and nonperimesencephalic subarachnoid hemorrhage (nPM-SAH) groups. The outcome was assessed according to the Glasgow outcome scale (GOS). The demographic data and clinical records including age, sex, smoking history, hypertension, diabetes, history of anticoagulant medication, Glasgow coma score (GCS), Hunt–Hess (HH) grades, and in-hospital complications and clinical outcomes were retrospectively reviewed and compared between the two groups. Results There were 45 patients (57.69%) in the PM-SAH group and 33 cases (42.30%) in the nPM-SAH group with the mean age of 53.98 ± 7.7 years. There were no significant differences between the two groups based on age, sex, smoking history, diabetes, hypertension, anticoagulation medication history, and HH grade at admission. The nPM-SAH group was significantly associated with a higher incidence of radiological and clinical vasospasm (p < 0.05). Moreover, the need for external ventricular drainage (EVD) placement because of the development of hydrocephalus was significantly higher in the nPM group (p < 0.05). Patients with PM-SAH had better clinical outcomes than those with nPM-SAH (p = 0.037). Conclusions Our results showed that patients with nonaneurysmal subarachnoid hemorrhage (NSAH) had favorable clinical outcomes. The PM group had better clinical outcomes and lower complication rates in comparison with the nPM group. Repeated digital subtraction angiography (DSA) examinations are strongly recommended for patients with nPM-SAH.
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spelling doaj-art-7be5a288b26e4fa1a345ec528c688c692025-08-20T03:06:41ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672021-03-01100103704110.1055/s-0040-1714302Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical OutcomesEhsan Alimohammadi0Paniz Ahadi1Ali Karbasforoushan2Shamsoddin Rahmani3Seyed Reza Bagheri4Alireza Abdi5Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, IranClinical Research Development Center of Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, IranDepartment of Anesthesiology, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, IranDepartment of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, IranDepartment of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, IranNursing and Midwifery School, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, IranBackground The present study aimed to investigate the risk factors, complications, and clinical outcomes of patients with nontraumatic, nonaneurysmal subarachnoid hemorrhage (NNSAH). Methods We retrospectively evaluated 78 consecutive patients with NNSAH admitted to our center between April 2009 and April 2019. Patients were divided into two groups based on the distribution of blood in the CT scan, perimesencephalic subarachnoid hemorrhage ( PM-SAH) and nonperimesencephalic subarachnoid hemorrhage (nPM-SAH) groups. The outcome was assessed according to the Glasgow outcome scale (GOS). The demographic data and clinical records including age, sex, smoking history, hypertension, diabetes, history of anticoagulant medication, Glasgow coma score (GCS), Hunt–Hess (HH) grades, and in-hospital complications and clinical outcomes were retrospectively reviewed and compared between the two groups. Results There were 45 patients (57.69%) in the PM-SAH group and 33 cases (42.30%) in the nPM-SAH group with the mean age of 53.98 ± 7.7 years. There were no significant differences between the two groups based on age, sex, smoking history, diabetes, hypertension, anticoagulation medication history, and HH grade at admission. The nPM-SAH group was significantly associated with a higher incidence of radiological and clinical vasospasm (p < 0.05). Moreover, the need for external ventricular drainage (EVD) placement because of the development of hydrocephalus was significantly higher in the nPM group (p < 0.05). Patients with PM-SAH had better clinical outcomes than those with nPM-SAH (p = 0.037). Conclusions Our results showed that patients with nonaneurysmal subarachnoid hemorrhage (NSAH) had favorable clinical outcomes. The PM group had better clinical outcomes and lower complication rates in comparison with the nPM group. Repeated digital subtraction angiography (DSA) examinations are strongly recommended for patients with nPM-SAH.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1714302nontraumatic nonaneurysmal subarachnoid hemorrhagedigital subtraction angiographyperimesencephalicnonperimesencephalicglasgow outcome scale
spellingShingle Ehsan Alimohammadi
Paniz Ahadi
Ali Karbasforoushan
Shamsoddin Rahmani
Seyed Reza Bagheri
Alireza Abdi
Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes
Indian Journal of Neurosurgery
nontraumatic nonaneurysmal subarachnoid hemorrhage
digital subtraction angiography
perimesencephalic
nonperimesencephalic
glasgow outcome scale
title Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes
title_full Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes
title_fullStr Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes
title_full_unstemmed Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes
title_short Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes
title_sort nontraumatic nonaneurysmal subarachnoid hemorrhage risk factors complications and clinical outcomes
topic nontraumatic nonaneurysmal subarachnoid hemorrhage
digital subtraction angiography
perimesencephalic
nonperimesencephalic
glasgow outcome scale
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1714302
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AT alikarbasforoushan nontraumaticnonaneurysmalsubarachnoidhemorrhageriskfactorscomplicationsandclinicaloutcomes
AT shamsoddinrahmani nontraumaticnonaneurysmalsubarachnoidhemorrhageriskfactorscomplicationsandclinicaloutcomes
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