Life expectancy after perimesencephalic subarachnoid hemorrhage

Area of Science:

• Neurology
• Neurosurgery
• Public Health

Background:

• Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNH) patients face uncertainty regarding long-term prognosis.
• These patients are often unfairly categorized as high-risk for insurance purposes.
• Previous studies lacked comprehensive long-term mortality data for PNH cohorts.

Purpose of the Study:

• To conduct a very long-term follow-up of a large PNH patient cohort.
• To compare the mortality rates of PNH patients with the general population.
• To address the long-term prognosis and insurance implications for PNH survivors.

Main Methods:

• A consecutive series of 160 PNH patients (1983-2005) were followed via telephone.
• Mortality data, including age and cause of death, were collected for deceased patients.
• Standardized mortality ratios (SMR) were calculated and compared to general population rates.

Main Results:

• The cohort comprised 160 patients with 1213 patient-years of follow-up.
• No recurrent subarachnoid hemorrhage events were reported.
• The observed mortality was lower than expected (SMR 0.61), indicating normal life expectancy.

Conclusions:

• Patients with perimesencephalic hemorrhage exhibit normal life expectancy.
• There is no increased risk of rebleeding or premature death in the long term.
• Physicians and insurance companies should not impose restrictions on PNH patients.