Subarachnoid haemorrhage of unknown aetiology.
Eighty-six of 996 patients with primary subarachnoid haemorrhage (SAH) had negative pan-angiography studies. These 86 patients with subarachnoid haemorrhage of unknown origin (SAH-NUD) were compared with 853 patients sustaining an aneurysmal bleed (SAH-A) admitted during the same period 1980-1989. The age and sex distribution of both groups were similar. The SAH-NUD group was in better condition on admission, with less blood evident on CT scan. All 16 (repeat control) angiography studies in the SAH-NUD group were negative. During a follow-up period ranging from 1 to 10 years (mean 5.4 years), two patients experienced rebleeding with negative repeat angiographies and subsequent total recovery. Using the Glasgow Outcome Scale (GOS) the final outcome was good in 86% of the study group and 54% of the aneurysm group. However, half of the SAH-NUD patients complained of persistent symptoms at long-term follow-up. Thus, despite a generally good prognosis, for a given individual SAH-NUD may be catastrophic with many residual symptoms persisting for the rest of the person's life.
Ronkainen
A
A
Department of Neurosurgery, University Hospital of Kuopio, Finland.
Hernesniemi
J
J
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed