Spontaneous Spinal Subarachnoid Hemorrhage: Presentation and Outcome

Area of Science:

• Neurology
• Neurosurgery
• Vascular Medicine

Background:

• Spontaneous spinal subarachnoid hemorrhage (SSAH) is a rare but serious condition.
• It can lead to significant medical complications and neurological deficits.
• Early recognition is crucial for patient management and outcomes.

Purpose of the Study:

• To investigate the clinical characteristics, complications, and outcomes of spontaneous spinal subarachnoid hemorrhage (SSAH).
• To identify risk factors and patient populations most susceptible to SSAH.
• To evaluate the effectiveness of current management strategies for SSAH.

Main Methods:

• Retrospective review of consecutive patients diagnosed with spontaneous SSAH (non-traumatic, non-iatrogenic) at Mayo Clinic Rochester (2000-2015).
• Collection and analysis of demographic data, clinical presentations, and comorbidities.
• Assessment of functional outcomes using the modified Rankin Scale (mRS) at discharge and follow-up.

Main Results:

• Eight patients (median age 70) with SSAH were identified.
• Common presentations included acute back pain/headache (7/8) and poorly controlled hypertension (7/8).
• Frequent complications included cord compression (50%), hyponatremia (63%), and vascular anomalies (25%) or vasculitis (25%).

Conclusions:

• SSAH should be suspected in patients with sudden severe back pain and headache, particularly with neurological deficits.
• Older individuals with poorly controlled hypertension are at increased risk.
• Mortality was 25% within 3 months, often linked to comorbidities; conservative management of cord compression is feasible.