[Non-aneurysmal subarachnoid hemorrhage: 60 cases].

INTRODUCTION

Spontaneous subarachnoid hemorrhage (SAH) is idiopathic in 15% of cases. They represent a group whose characteristics are different from those with an aneurysmal etiology. We present a retrospective longterm follow up of 60 patients, analyzing symptomatology, complications and evolution and identify a subgroup of patients with a perimesencephalic pattern (PMP) in computed tomography (CT) for their excellent prognosis.

METHODS

We collected information on 60 patients admitted to our center between 1992 and 2000 and divided them into three groups, according to neuroimage: 26 had a PMP, 28 showed an aneurysmal pattern (AP), and 6 patients had normal TC, with complete arteriographic study. Length of follow-up was 6-24 months.

RESULTS

All of the 26 patients with SAH and PPM pattern were rated grade I-II on the Hunt-Hess scale. None of them had complications during hospital stay and at long term, 22 (84%) were asymptomatic, while 4 (16%) reported cephalea. Out of 28 patients with SAH and AP, 22 were rated Hunt-Hess Scale grade I and II (78%), 5 grade III (18%) and one patient was rated grade IV. Rebleeding caused death in one of them, and two required drainage for hydrocephalia. A total of 68% (19 patients) were asymptomatic and the others complained of cephalea.

CONCLUSIONS

We stress the good evolution of nonaneurysmal SAH at short and long term, especially those following a PMP with absence of complication.