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Subarachnoid hemorrhage of unexplained cause
S Giombini1, M G Bruzzone, F Pluchino
1Division of Neurosurgery, Istituto Neurologico C. Besta, Milan, Italy.
Neurosurgery
|February 1, 1988
Summary
Patients with subarachnoid hemorrhage (SAH) of unknown cause show a good prognosis. Further investigation is sometimes needed to identify treatable conditions like arteriovenous malformations, ensuring a positive recovery for most patients.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Subarachnoid hemorrhage (SAH) can present without an identifiable cause after initial investigations.
- Understanding the prognosis and optimal management for these cases is crucial.
Purpose of the Study:
- To evaluate the outcomes and recurrence rates in patients with cryptogenic SAH.
- To discuss the utility of repeat angiography and identify potential underlying pathologies.
Main Methods:
- A 7-year observational study of 58 patients with SAH and negative initial investigations.
- Clinical assessment, neuroradiological imaging, and repeat panangiography were performed.
- Surgical treatment was undertaken when a cause was identified.
Main Results:
- A low rebleeding rate of 3.4% was observed.
- 89% of patients achieved a good outcome with return to normal activities.
- A cerebral arteriovenous malformation was identified and successfully treated in one patient after repeat angiography.
Conclusions:
- Patients with SAH of unknown cause generally have a favorable prognosis.
- Repeat angiography may reveal treatable lesions, and small infundibular dilations warrant consideration.
- Early identification and treatment contribute to positive long-term outcomes.