A prospective study on angiographically negative non aneurysmal spontaneous subarachnoid hemorrhage
Boni Krishna Chaitanya, Amit Dahiya, S V Rege, Gourav Jatav
Aim: To analyze patients suffering from angiographic-negative and NPM-SAH.Material and methods: The present prospective study was conducted in the department of neurosurgery of Sri Aurobindo Institute of Medical Sciences, Indore from January 2019 to December 2020. The study comprised of 60 spontaneous subarachnoid hemorrhage patients diagnosed with initial non-contrast CT followed by CTA/MRA Brain. Initial NCCT brain suggestive of subarachnoid hemorrhage and initial negative CTA/MRA patients can be divided into perimesencephalic and nonperimesencephalic pattern. Patients of non-aneurysmal spontaneous subarachnoid hemorrhage were assessed by initial Hunt & Hess scale, GCS, modified fisher grade, WFNS grade (admission status) and modified Rankin scale for clinical outcome.Results: In this study, WFNS grading 3 and 4 was reported among 14.3%, 23.81% and 2.56%, 0% of the subjects having non-perimesencephalic and perimesencephalic hemorrhage respectively with statistically significant difference as p<0.05. Slight and moderate disability was only found among subjects with nonperimesencephalic hemorrhage while no moderate/slight disability was reported among subjects having perimesencephalic hemorrhage. In this study 95.2 % among nonperimesencephalic type SAH having favourable outcome in comparison to 100 % in perimesencephalic type SAH patients at 6 months.Conclusion: nPMN-SAH patients are associated with higher complication rate and higher incidence of aneurysm. Therefore, we strongly recommend a repeat angiogram in patients with nPMN-SAH pattern on initial imaging.