Ronkainen A, Hernesniemi J
Department of Neurosurgery, University Hospital of Kuopio, Finland.
Acta Neurochir (Wien). 1992;119(1-4):29-34. doi: 10.1007/BF01541778.
Eighty-six of 996 patients with primary subarachnoid haemorrhage (SAH) had negative pan-angiography studies. These 86 patients with subarachnoid haemorrhage of unknown origin (SAH-NUD) were compared with 853 patients sustaining an aneurysmal bleed (SAH-A) admitted during the same period 1980-1989. The age and sex distribution of both groups were similar. The SAH-NUD group was in better condition on admission, with less blood evident on CT scan. All 16 (repeat control) angiography studies in the SAH-NUD group were negative. During a follow-up period ranging from 1 to 10 years (mean 5.4 years), two patients experienced rebleeding with negative repeat angiographies and subsequent total recovery. Using the Glasgow Outcome Scale (GOS) the final outcome was good in 86% of the study group and 54% of the aneurysm group. However, half of the SAH-NUD patients complained of persistent symptoms at long-term follow-up. Thus, despite a generally good prognosis, for a given individual SAH-NUD may be catastrophic with many residual symptoms persisting for the rest of the person's life.
996例原发性蛛网膜下腔出血（SAH）患者中，86例全脑血管造影检查结果为阴性。将这86例不明原因蛛网膜下腔出血（SAH-NUD）患者与1980年至1989年同期收治的853例动脉瘤性出血（SAH-A）患者进行比较。两组的年龄和性别分布相似。SAH-NUD组入院时状况较好，CT扫描显示出血较少。SAH-NUD组的所有16例（复查对照）血管造影检查结果均为阴性。在1至10年（平均5.4年）的随访期内，2例患者再次出血，复查血管造影结果为阴性，随后完全康复。根据格拉斯哥预后量表（GOS），研究组86%的患者最终预后良好，动脉瘤组为54%。然而，一半的SAH-NUD患者在长期随访中抱怨有持续症状。因此，尽管总体预后良好，但对于特定个体而言，SAH-NUD可能是灾难性的，许多残留症状会伴随患者余生。
