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[Perimesencephalic subarachnoid hemorrhage: clinical and computer tomography aspects]
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|April 1, 1995
Summary
Nonaneurysmal subarachnoid hemorrhage often presents with a perimesencephalic blood distribution on CT scans, indicating an excellent prognosis. Ruptured aneurysms rarely cause this pattern, necessitating careful angiographic assessment.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Subarachnoid hemorrhage (SAH) is a critical neurological condition.
- Differentiating aneurysmal from nonaneurysmal SAH is crucial for patient management and prognosis.
- Computed Tomography (CT) imaging plays a key role in initial SAH diagnosis and blood distribution assessment.
Purpose of the Study:
- To compare the blood distribution patterns on CT scans between patients with nonaneurysmal SAH and those with aneurysmal SAH.
- To evaluate the long-term prognosis and functional capacity of patients with nonaneurysmal SAH.
- To determine the association between perimesencephalic blood distribution and the etiology of SAH.
Main Methods:
- Retrospective study comparing CT blood distribution in 26 nonaneurysmal SAH patients (confirmed by negative cerebral angiograms) with 76 aneurysmal SAH patients.
- CT scans were analyzed 72 hours post-bleeding.
- Clinical condition and functional capacity were assessed 4-60 months after the bleeding episode.
Main Results:
- Perimesencephalic blood distribution was observed in 62% of nonaneurysmal SAH cases.
- Aneurysmal SAH typically showed more widespread blood distribution, with only one case presenting a perimesencephalic pattern.
- 80% of patients with nonaneurysmal SAH experienced no limitations in daily functional capacity.
Conclusions:
- The perimesencephalic pattern is a frequent finding in nonaneurysmal SAH.
- Patients with nonaneurysmal SAH and perimesencephalic blood distribution exhibit an excellent prognosis.
- Perimesencephalic SAH is rarely caused by ruptured aneurysms, underscoring the need for comprehensive angiographic evaluation to exclude underlying aneurysms.