Abstract
Angiogram-negative subarachnoid hemorrhage (anSAH) accounts for 15% of spontaneous SAH. Recent studies suggest the outcome and diagnostic yield in anSAH differ based on initial bleeding pattern. We present a single-center experience in managing patients with SAH and negative initial digital-subtracted angiogram (DSA). Records of all patients with anSAH were reviewed. Bleeding pattern was determined from computed tomography (CT) and was categorized as perimesencephalic (PMN), diffuse, cortical, or xanthochromia (blood not detectable by CT). Diagnostic yield, in-hospital complications, and outcome parameters were analyzed. Of 352 patients admitted with spontaneous SAH from 2003 to 2008, 68 (19.3%) had negative initial DSA. Mean age was 59.5 ± 14, and 33 were female. By CT, 27 (39.7%) patients exhibited PMN SAH, 33 (48.5%) diffuse SAH, 6 (8.8%) cortical SAH, and 2 (2.9%) xanthochromia only. Sixty-one patients had good Hunt and Hess (H/H) grades (I-III) and seven had poor grades (IV-V). Additional diagnostic studies included repeat angiogram (54), brain and C-spine magnetic resonance imaging (20), and repeat CTA (15). A structural bleeding cause was determined in six (8.8%) patients, 4 of which had diffuse SAH and 2 cortical SAH. A...Continue Reading
References
Oct 19, 1991·Lancet·G J RinkelJ van Gijn
Jul 1, 1990·Neurosurgery·H IwanagaM Nagai
Apr 1, 1985·Neurology·J van GijnA Hijdra
Jan 1, 1993·Acta neurochirurgica·A N PintoJ Campos
Sep 1, 1993·Stroke; a Journal of Cerebral Circulation·G J RinkelE F Wijdicks
May 1, 1996·Acta Neurologica Scandinavica·A KaimW Steinbrich
Apr 1, 1997·Stroke; a Journal of Cerebral Circulation·S E VermeerA Algra
Aug 19, 2000·Acta neurochirurgica·J M SheehanN F Kassell
Feb 7, 2001·Brain : a Journal of Neurology·J van Gijn, G J Rinkel
Jun 21, 2003·Journal of Neurosurgery·Mehmet A TopcuogluAneesh B Singhal
Dec 29, 2007·Neurosurgery·Andrew S LittleRobert F Spetzler
Apr 25, 2008·Clinical Neurology and Neurosurgery·Haruki YamakawaToru Iwama
Jun 27, 2008·Neurosurgery·Norberto Andaluz, Mario Zuccarello
Oct 31, 2008·Neurocritical Care·H Bart van der WorpGabriël J E Rinkel
Jan 23, 2009·Journal of Neurology·M R GermansW P Vandertop
Feb 3, 2009·Neurocritical Care·Karen G HirschWendy C Ziai
Mar 12, 2009·Neurocritical Care·Ferdinand K HuiY Jonathan Zhang
Apr 14, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Dong-Hun KangIn-Suk Hamm
May 5, 2009·Neurosurgical Focus·Jobyna WhitingBrian Hoh
Oct 17, 2009·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Jaejoon LeeHeui-Soo Moon
Nov 28, 2009·AJNR. American Journal of Neuroradiology·R AgidM Söderman
Aug 3, 2010·Journal of Neurosurgery·Homajoun MaslehatyHubertus Maximilian Mehdorn
Mar 2, 2011·Emergency Radiology·Juan Pablo CruzLyne Noel de Tilly
Apr 30, 2011·Neurocritical Care·Edgar A SamaniegoItalo Linfante
May 14, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·A FernandezH S Mangat
Citations
May 9, 2013·Neurocritical Care·Bappaditya RayEugene Gu
Jan 15, 2014·Neurocritical Care·Vivien H LeeShyam Prabhakaran
Jul 3, 2015·Neurocritical Care·Peter KangRajat Dhar
Aug 26, 2014·Journal of the American Pharmacists Association : JAPhA·Jonathan A BainAaron M Cook
Aug 8, 2015·Journal of Neurosurgery·Jared NarvidVan V Halbach
Jul 27, 2015·World Neurosurgery·Ralph Rahme, Nilesh A Vyas
Sep 17, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Beatrice CannetiJosé Vivancos
Mar 25, 2015·Journal of Neurointerventional Surgery·Adam N WallaceColin P Derdeyn
Feb 15, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Brian P WalcottChristopher S Ogilvy
Jul 8, 2015·Clinical Neurology and Neurosurgery·Adam N WallaceColin P Derdeyn
Nov 26, 2014·Neurocritical Care·Adnan I QureshiM Fareed K Suri
Sep 23, 2014·Journal of Critical Care·Collin SprenkerSiviero Agazzi
Jul 9, 2014·World Neurosurgery·Anish KapadiaR Loch Macdonald
May 28, 2016·Current Neurology and Neuroscience Reports·H Steven Block
May 28, 2016·Radiology·Christopher A PotterDavid R Haynor
Jul 19, 2016·World Neurosurgery·David P BrayE Sander Connolly
Jul 30, 2014·Neurosurgery·Jason A EllisE Sander Connolly
Oct 14, 2017·Journal of Neurosurgery·Gelareh SadighJason W Allen
Dec 20, 2014·Stroke; a Journal of Cerebral Circulation·Vivek B KalraAjay Malhotra
Nov 7, 2013·Stroke; a Journal of Cerebral Circulation·Amanda RayaRajat Dhar
Apr 19, 2019·Neurology·Cody L NesvickAlejandro A Rabinstein
May 12, 2019·Journal of Neurointerventional Surgery·Katarina DakayShawna Cutting
Mar 29, 2020·Journal of the Chinese Medical Association : JCMA·Jin Pyeong JeonYong Jun Cho
Jun 27, 2020·British Journal of Neurosurgery·Matthew K McIntyreChristian A Bowers
Jun 3, 2017·Neurosurgery·Fawaz Al-MuftiSachin Agarwal
Aug 15, 2019·Acta neurochirurgica·Midhun MohanUNKNOWN British Neurosurgical Trainee Research Collaborative
Sep 13, 2020·European Radiology·Yuanjian FangJianmin Zhang
Dec 3, 2016·Der Anaesthesist·U Jaschinski
May 26, 2017·BioMed Research International·Liang XuJing Xu
Jun 1, 2018·Neurosurgery·Gelareh SadighJason W Allen
Aug 20, 2020·Neuroradiology·Diego Páez-GrandaJoaquín Zamarro
Oct 13, 2019·World Neurosurgery·Matthew McIntyreChristian A Bowers
Apr 28, 2021·Neuroimaging Clinics of North America·Anthony S Larson, Waleed Brinjikji
May 19, 2021·World Journal of Clinical Cases·Juan LiBin Du
Dec 22, 2021·Neurocritical Care·Feras AkbikOfer Sadan