An analysis of 88 patients with diffuse and benign perimesencephalic subarachnoid hemorrhage

Neal B. Patel, Amrita D. Patel, Jared Wilkinson, Nicholas G. Gianaris, Troy D. Payner, Thomas J. Leipzig, Shaheryar Ansari, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Study Aims Perimesencephalic subarachnoid hemorrhage (PMSAH) was previously defined as a variant of subarachnoid hemorrhage (SAH) associated with a relatively benign clinical presentation and better outcomes than aneurysmal SAH. However, several prior studies have shown complications associated with PMSAH including vasospasm and hydrocephalus, and the need for follow-up imaging. We therefore reviewed our experience to further characterize the clinical consequences of PMSAH. Materials and Methods Eighty-eight consecutive patients who sustained spontaneous intracranial SAH and whose cerebral angiograms did not show any obvious source for SAH were retrospectively studied to characterize their prognosis and outcome based on SAH pattern. Glasgow Coma Scale and Hunt-Hess scores on admission, the incidence of vasospasm or hydrocephalus, the need for an external ventricular drain, and shunt dependence, along with Glasgow outcome score (GOS) at discharge and follow-up, were used to draw comparisons between perimesencephalic and diffuse SAH patient populations. Results Patients with perimesencephalic SAH differed statistically (p < 0.05) from patients with diffuse SAH in regard to age, Hunt-Hess score on presentation, hospital length of stay, GOS at discharge, and incidence of hydrocephalus, angiographic vasospasm, and clinical vasospasm. Conclusion Our data demonstrate that although the patients with perimesencephalic SAH fared better than those with diffuse SAH, their outcomes were worse than those of similar patients with PMSAH who have been previously reported in the literature.

Original languageEnglish
Pages (from-to)299-304
Number of pages6
JournalJournal of Neurological Surgery, Part A: Central European Neurosurgery
Volume75
Issue number4
DOIs
StatePublished - 2014

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Subarachnoid Hemorrhage
Hydrocephalus
Length of Stay
Glasgow Coma Scale
Incidence
Angiography

Keywords

  • hydrocephalus
  • outcome
  • perimesencephalic
  • prognosis
  • subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

An analysis of 88 patients with diffuse and benign perimesencephalic subarachnoid hemorrhage. / Patel, Neal B.; Patel, Amrita D.; Wilkinson, Jared; Gianaris, Nicholas G.; Payner, Troy D.; Leipzig, Thomas J.; Ansari, Shaheryar; Cohen-Gadol, Aaron.

In: Journal of Neurological Surgery, Part A: Central European Neurosurgery, Vol. 75, No. 4, 2014, p. 299-304.

Research output: Contribution to journalArticle

Patel, Neal B. ; Patel, Amrita D. ; Wilkinson, Jared ; Gianaris, Nicholas G. ; Payner, Troy D. ; Leipzig, Thomas J. ; Ansari, Shaheryar ; Cohen-Gadol, Aaron. / An analysis of 88 patients with diffuse and benign perimesencephalic subarachnoid hemorrhage. In: Journal of Neurological Surgery, Part A: Central European Neurosurgery. 2014 ; Vol. 75, No. 4. pp. 299-304.
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