Yield of spinal imaging in nonaneurysmal, nonperimesencephalic subarachnoid hemorrhage.
OBJECTIVE
We studied the yield of MRI of the spinal neuraxis in patients with nonperimesencephalic subarachnoid hemorrhage (NPSAH).


METHODS
In a prospective, multicenter study, we performed T1-weighted and T2-weighted MRI of the spinal axis in a consecutive series of patients with a spontaneous NPSAH without intracranial vascular pathology on intracranial vascular imaging.


RESULTS
A spinal origin of the hemorrhage was found in 3 of 75 patients (4%; 95% confidence interval 0-8.4). The lesions were 1 lumbar ependymoma and 2 cervical cavernous malformations. All 3 patients presented without focal neurologic deficits and 2 had a CT-negative subarachnoid hemorrhage but positive lumbar puncture. Patients with a spinal origin were younger than patients without a spinal origin (38 vs 56 years; p < 0.05), which was the only significant difference between groups.


CONCLUSIONS
The yield and clinical relevance of MRI of the spinal axis in patients who present with NPSAH is low. We do not recommend routine MRI of the spinal axis in this patient population, but it might be justified in a subgroup of patients.
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands. mrgermans@hotmail.com.
Menno R
MR
Germans
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
Bert A
BA
Coert
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
Charles B L M
CB
Majoie
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
René
R
van den Berg
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
Geert
G
Lycklama À Nijeholt
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
Gabriël J E
GJ
Rinkel
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
Dagmar
D
Verbaan
From the Department of Neurosurgery, Neurosurgical Center Amsterdam (M.R.G., B.A.C., D.V., W.P.V.), and the Department of Neuroradiology (C.B.L.M.M., R.v.d.B.), Academic Medical Center, Amsterdam; the Department of Radiology (G.L.N.), Medical Center Haaglanden, the Hague; and the Department of Neurology & Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands.
W Peter
WP
Vandertop
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013116:Spinal Cord / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000473:pathology