Outcome Predictors of Non-Aneurysmal Spontaneous Subarachnoid Hemorrhage: A Retrospective Analysis in A Tertiary Care Center
Journal Title: International Journal of Neurology and Neurosurgery - Year 2018, Vol 10, Issue 3
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.
Authors and Affiliations
Raghavendra Nayak
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- EP ID EP562351
- DOI 10.21088/ijnns.0975.0223.10318.18
- Views 65
- Downloads 0
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