title: Non-aneurysmal subarachnoid hemorrhage in 173 patients: a prospective study of long-term outcome.
abstract: OBJECTIVE
  In some patients with subarachnoid hemorrhage (SAH) a bleeding source cannot be identified. Perimesencephalic (PM) SAH is assumed to have an excellent outcome. Our objective was to analyze the long-term physical and psychological outcome of patients after non-aneurysmal SAH.
  
  
  METHODS
  One hundred and seventy-three patients met the inclusion criteria. Short-term follow-up 6 months after SAH was assessed according to the modified Rankin Scale (0-2 favorable). A short-form health survey with 36 questions (SF-36) and eight scales was used as questionnaire for long-term follow-up.
  
  
  RESULTS
  Thirty-seven answers were received from the two groups, PM and non-perimesencephalic (NPM) SAH, on average 76 months after ictus (range 1.5-14 years). PM- and NPM-SAH without Fisher grade 3 blood pattern have excellent short-term outcomes. The quality of life (QoL) is significantly reduced after non-aneurysmal SAH, especially in NPM-SAH. In particular, patients with a Fisher 3 blood pattern had significantly higher risks for cerebral vasospasm, delayed cerebral ischaemia, unfavorable outcome, reduced QoL and mortality in short- and long-term follow-up.
  
  
  CONCLUSIONS
  Excluding rolph, only patients with a PM-SAH have a similar QoL at long-term follow-up compared to the standard population. Patients with NPM-SAH have a significantly decreased QoL in long-term follow-up. Furthermore, the Fisher 3 blood pattern group in particular had a significantly worse outcome - at short-term and long-term follow-up. Therefore the NPM-SAH group was stratified into patients with Fisher 3 blood pattern and patients without Fisher 3 in further investigations.
authors.affiliation: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Konczalla
authors.affiliation: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schmitz
authors.affiliation: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Kashefiolasl
authors.affiliation: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Senft
authors.affiliation: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Seifert
authors.affiliation: Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Platz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D013345:Subarachnoid Hemorrhage / Q000145:classification*
keywords: SAH; SF-36; aneurysm; long-term outcome; non-aneurysmal; non-perimesencephalic; perimesencephalic; prepontine; short-term; subarachnoid hemorrhage