Short- and long-term outcomes in non-aneurysmal non-perimesencephalic subarachnoid hemorrhage

Data de publicació: 01/08/2016

Autors de IIS La Fe

Aida Lago Martín

Autor
Rogelio Alberto Lopez Cuevas

Autor
José Ignacio Tembl Ferrairo

Autor
Gerardo Fortea Cabo

Autor
David Gorriz Romero

Autor
Fernando Aparici Robles

Autor
Vera Parkhutik Matveeva

Autor

Grups d'Investigació

Hemostasia, Trombosis, Arteriosclerosis y Biología vascular

Investigador Principal

Pilar Medina Badenes

Abstract

Objective: Our aim was to assess the short-and long-term prognosis in patients suffering from non-aneurysmal non-perimesencephalic SAH (Na-NPM-SAH). Methods: Based on admission CT-scan, SAH was categorized as perimesencephalic (PM) or non-perimesencephalic (NPM). Based on digital subtraction angiography (DSA) results, patients were classified as normal DSA (Na-SAH) or aneurysmal SAH (aSAH). Between 1997 and 2010, 67 of 571 patients with non-traumatic SAH (11.7%) suffered from non-aneurysmal non-perimesencephalic SAH. Retrospective analyses of the 67 patients were undertaken, and compared with the aneurysmal SAH group. Long-term follow-up was assessed. Results: The cohort consisted of 67 Na-NPM-SAH patients, mean age 54.8 years (range: 21-84), 56.7% male. Acute phase: 10.4% mortality and 3% rebleeding (two patients) during the acute phase. Long-term: extensive follow-up was possible in all except one of the survivors at discharge. Mortality was 6.6% during the 510 patient-years follow-up period (median follow-up time per patient, 8.95 years); rebleeding rate was 0-1.6%. An aneurysmal source was found in 13% of patients who underwent a second angiography. Aneurysmal SAH: 312 patients, with confirmed aneurysm by angiography. The mortality rate for Na-NPM-SAH during the acute phase was 10.4%, vs. 20% for aneurysmal SAH in the general database, p = 0.049. Discussion: Na-NPM-SAH patients without an identifiable bleeding source on initial angiography might have a more benign short-and long-term prognosis than aneurysmal SAH patients. Our study confirms an important diagnostic advantage of a second arteriography. Still, despite the major concern of an undetected aneurysm, the long-term rebleeding rate was low in this subgroup of patients.

Dades de la publicació

ISSN/ISSNe:: 0161-6412, 1743-1328
Tipus:: Article
Pàgines:: 692-697
DOI:: 10.1080/01616412.2016.1200306
PubMed:: 27338138
Factor d'Impacte:: 0,633 SCImago ℠
Quartil:: Q2 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Lago A:: a Department of Neurology , HU La Fe , Valencia , Spain
Lopez-Cuevas R:: a Department of Neurology , HU La Fe , Valencia , Spain
Tembl JI:: a Department of Neurology , HU La Fe , Valencia , Spain
Fortea G:: a Department of Neurology , HU La Fe , Valencia , Spain
Gorriz D:: a Department of Neurology , HU La Fe , Valencia , Spain
Aparici F:: b Department of Radiology , HU La Fe , Valencia , Spain
Parkhutik V:: a Department of Neurology , HU La Fe , Valencia , Spain

Keywords

SAH; Non-aneurysmal SAH; Non-perimesencephalic SAH; Outcome; SAH of unknown origin

Campos d'Estudi

Projectes associats

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AVANCES EN EL ESTUDIO DE LA REACTIVIDAD PLAQUETARIA Y SU INTERACCION CON LOS ERITROCITOS: BASES MOLECUALRES Y APLICABILIDAD CLINICO-FARMACOLOGICA

Investigador Principal: JUANA VALLES GINER

PI03/0270 . INSTITUTO DE SALUD CARLOS III . 2004

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Investigador Principal: ENRIQUE ALBORCH DOMÍNGUEZ

RD06/0026/0006 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN INSTITUTO DE INVESTIGACIÓN SANITARIA DE SANTIAGO DE COMPOSTELA (FIDIS); FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006