title: MRI-detection rate and incidence of lumbar bleeding sources in 190 patients with non-aneurysmal SAH.
abstract: BACKGROUND
  Up to 15% of all spontaneous subarachnoid hemorrhages (SAH) have a non-aneurysmal SAH (NASAH). The evaluation of SAH patients with negative digital subtraction angiography (DSA) is sometimes a diagnostic challenge. Our goal in this study was to reassess the yield of standard MR-imaging of the complete spinal axis to rule out spinal bleeding sources in patients with NASAH.
  
  
  METHODS
  We retrospectively analyzed the spinal MRI findings in 190 patients with spontaneous NASAH, containing perimesencephalic (PM) and non-perimesencephalic (NPM) SAH, diagnosed by computer tomography (CT) and/or lumbar puncture (LP), and negative 2nd DSA.
  
  
  RESULTS
  190 NASAH patients were included in the study, divided into PM-SAH (n = 87; 46%) and NPM-SAH (n = 103; 54%). Overall, 23 (22%) patients had a CT negative SAH, diagnosed by positive LP. MR-imaging of the spinal axis detected two patients with lumbar ependymoma (n = 2; 1,05%). Both patients complained of radicular sciatic pain. The detection rate raised up to 25%, if only patients with radicular sciatic pain received an MRI.
  
  
  CONCLUSIONS
  Routine radiological investigation of the complete spinal axis in NASAH patients is expensive and can not be recommended for standard procedure. However, patients with clinical signs of low-back/sciatic pain should be worked up for a spinal pathology.
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Sepide
authors.initials: S
authors.lastname: Kashefiolasl
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Brawanski
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Platz
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Bruder
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Senft
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Marquardt
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.affiliation: Institute of Neuroradiology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tritt
authors.affiliation: Department of Neurosurgery, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Konczalla
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction / Q000379:methods*; D004806:Ependymoma / Q000175:diagnosis; D005260:Female; D006261:Headache / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012585:Sciatica / Q000150:complications / Q000000981:diagnostic imaging; D013129:Spinal Puncture; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D055815:Young Adult