Outcome correlates with blood distribution in subarachnoid hemorrhage of unknown origin

Woznica, M.; Rosahl, Steffen K.; Berlis, Ansgar; Weyerbrock, Astrid

doi:10.1007/s00701-009-0525-9

Cited by 15 publications

(13 citation statements)

References 14 publications

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“…13,16,25 A comparison between PM-and NPM-SAH revealed a trend towards an unfavorable outcome for NPM-SAH (p = 0.09), which supports recent data. 1,16,25 The NPM-SAH group without a Fisher Grade 3 bleeding pattern had similar and often favorable outcomes (87%) compared with the PM-SAH group (90%; Table 1). Accordingly, patients with an NPM-SAH and without a Fisher Grade 3 bleeding pattern also had a significantly better outcome compared with patients with NPM-SAH and a Fisher Grade 3 bleeding pattern (p < 0.05, OR 2.7).…”

Section: Incidence Of Nasah and Sah Patternsupporting

confidence: 76%

“…2 and 3; Table 2), but data for NASAH are scarce and mostly only describe higher blood volume and rebleeding rates, resulting in worse admission status and worse outcome. 4,13,25 Data for aSAH also remain scarce and describe a worse outcome 13 or nonreduced 30-day case fatality. 9 However, aCP use was significantly higher in the NPM-SAH group compared with the PM-SAH group (28% vs 11%; p < 0.01; Table 1).…”

Section: Fig 2 Graph Showing Percent Increase From Interval 1999-20mentioning

confidence: 99%

“…Meanwhile, the observation of Fisher Grade 3 bleeding patterns increased from 15% (1999-2001) to 26% (2011-2013). In patients suffering from NASAH, favorable outcomes were significantly associated with the SAH pattern on initial CT. 8,25 A Fisher Grade 3 bleeding pattern represented a Table 3) and death (OR 3.0) compared with a NPM non-Fisher Grade 3 bleeding pattern, as described earlier. 13,16,25 A comparison between PM-and NPM-SAH revealed a trend towards an unfavorable outcome for NPM-SAH (p = 0.09), which supports recent data.…”

Section: Incidence Of Nasah and Sah Patternmentioning

confidence: 99%

“…In patients suffering from NASAH, favorable outcomes were significantly associated with the SAH pattern on initial CT. 8,25 A Fisher Grade 3 bleeding pattern represented a Table 3) and death (OR 3.0) compared with a NPM non-Fisher Grade 3 bleeding pattern, as described earlier. 13,16,25 A comparison between PM-and NPM-SAH revealed a trend towards an unfavorable outcome for NPM-SAH (p = 0.09), which supports recent data. 1,16,25 The NPM-SAH group without a Fisher Grade 3 bleeding pattern had similar and often favorable outcomes (87%) compared with the PM-SAH group (90%; Table 1).…”

Section: Incidence Of Nasah and Sah Patternmentioning

confidence: 99%

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Increasing numbers of nonaneurysmal subarachnoid hemorrhage in the last 15 years: antithrombotic medication as reason and prognostic factor?

Konczalla¹,

Kashefiolasl²,

Brawanski³

et al. 2016

JNS

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S ubarachnoid hemorrhage (SAH) is usually caused by intracranial aneurysm rupture. However, in up to 20% of patients with SAH, results of cerebral angiography, CT, and MRI are negative for aneurysms or other vascular malformations. 2,7,11 More recent data show an increasing number of cases of spontaneous SAH 18,24 as well as nonaneurysmal SAH (NASAH). 15,16 Long-term dipyridamole and warfarin use were associated with an increased risk for aneurysmal SAH (aSAH), whereas the data for low-dose acetylsalicylic acid (LDA) were inconsistent. 10,14,21 Therefore, we analyzed our institutional database for patients suffering from angiography-negative SAH. The aim of the study was to identify risk factors for the increase of NASAH as well as analyze outcome.abbreviatioNs aCP = systemic anticoagulation or antiplatelet agent; aSAH = aneurysmal subarachnoid hemorrhage; CVS = cerebral vasospasm; DCI = delayed cerebral infarction; DSA = digital subtraction angiography; LDA = low-dose acetylsalicylic acid; mRS = modified Rankin Scale; NASAH = nonaneurysmal SAH; NPM = nonperimesencephalic; PM = perimesencephalic; SAH = subarachnoid hemorrhage; WFNS = World Federation of Neurosurgical Societies.

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Section: Incidence Of Nasah and Sah Patternsupporting

confidence: 76%

Section: Fig 2 Graph Showing Percent Increase From Interval 1999-20mentioning

confidence: 99%

Section: Incidence Of Nasah and Sah Patternmentioning

confidence: 99%

Section: Incidence Of Nasah and Sah Patternmentioning

confidence: 99%

See 2 more Smart Citations

Increasing numbers of nonaneurysmal subarachnoid hemorrhage in the last 15 years: antithrombotic medication as reason and prognostic factor?

Konczalla¹,

Kashefiolasl²,

Brawanski³

et al. 2016

JNS

View full text Add to dashboard Cite

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“…Unfortunately, data on outcome in patients suffering from angiogram-negative and non-perimesencephalic (NPM) SAH are published often only in small case series [1,[7][8][9][10][11][12][13][14], and data is scarce for series with more than 50 patients [5,15,16].…”

Section: Introductionmentioning

confidence: 98%

Clinical outcome and prognostic factors of patients with angiogram-negative and non-perimesencephalic subarachnoid hemorrhage: benign prognosis like perimesencephalic SAH or same risk as aneurysmal SAH?

et al. 2014

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Subarachnoid hemorrhage (SAH) is usually caused by a ruptured intracranial aneurysm. However, in some patients, no source of hemorrhage might be detected despite repeated digital subtraction angiography (DSA). Our objective was to analyze factors influencing the clinical outcome in patients suffering from non-aneurysmal and non-perimesencephalic (NPM) SAH. Between 1999 and 2011, 68 of 1,188 patients with SAH (5.7%) suffered from non-aneurysmal and NPM-SAH. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months (mRS 0-2 favorable vs. 3-6 unfavorable). In patients with angiogram-negative and NPM-SAH, favorable outcome was achieved in 56 patients (82.4%). In the multivariate analysis, age <65 years and non-Fisher 3 bleeding pattern were significantly associated with favorable outcome. Angiogram-negative and NPM-SAH had good prognoses. Patients with non-Fisher-type 3 bleeding had excellent outcomes similar to patients with perimesencephalic SAH, but patients with Fisher-type 3 bleeding were at risk for poor outcome like aneurysmal SAH patients due to cerebral vasospasm and delayed cerebral ischemia. Age and bleeding type were detected as prognostic factors in the multivariate analysis.

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Nonaneurysmal Subarachnoid Hemorrhage: An Update

Kim

Lawson

Hoh

2012

Curr Atheroscler Rep

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Nonaneurysmal subarachnoid hemorrhage (NA-SAH) constitutes a heterogeneous group of patients, both perimesencephalic (PMN-SAH) and non-perimesencephalic (nPMN-SAH). Despite many reports and case series, the etiology of NA-SAH remains uncertain. The differences in clinical course and outcome between PMN-SAH and nPMN-SAH are evident and have to be taken into consideration at the time of admission, as aggressive diagnostic evaluation and management are required for latter patient. In terms of diagnostic evaluation, the most important determination is to differentiate PMN-SAH from nPMN-SAH and aneurysmal SAH. PMN-SAH can be distinguished on CT in the majority of patients, but should be confirmed by a negative cerebral angiography. In addition, Convexal NA-SAH is another important subtype of NA-SAH associated with diverse etiologies and symptoms, although prognosis is generally favorable.

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Outcome correlates with blood distribution in subarachnoid hemorrhage of unknown origin

Abstract: In SAH of unknown origin, a new classification allows to predict outcome based on the extent of blood on CT.

Cited by 15 publications

References 14 publications

Increasing numbers of nonaneurysmal subarachnoid hemorrhage in the last 15 years: antithrombotic medication as reason and prognostic factor?

Increasing numbers of nonaneurysmal subarachnoid hemorrhage in the last 15 years: antithrombotic medication as reason and prognostic factor?

Clinical outcome and prognostic factors of patients with angiogram-negative and non-perimesencephalic subarachnoid hemorrhage: benign prognosis like perimesencephalic SAH or same risk as aneurysmal SAH?

Nonaneurysmal Subarachnoid Hemorrhage: An Update

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