gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Clinical outcome of patients with non-aneurysmal subarachnoid hemorrhage: prognostic factors and outcome

Meeting Abstract

  • J. Konczalla - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Deutschland
  • E. Güresir - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Deutschland
  • H. Vatter - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Deutschland
  • V. Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.10.12

DOI: 10.3205/11dgnc176, URN: urn:nbn:de:0183-11dgnc1764

Published: April 28, 2011

© 2011 Konczalla et al.
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Outline

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Objective: Subarachnoid hemorrhage (SAH) is caused chiefly by ruptured cerebral aneurysms. In some patients cerebral angiography is negative for an aneurysm. Our objective was to analyze patient characteristics, clinical outcome and prognostic factors in patients suffering from non-aneurysmal-SAH.

Methods: From 1999 to 2009, 125 patients had a non-aneurysmal SAH. Clinical and radiological characteristics were entered into our prospectively conducted database. All patients underwent digital subtraction angiography (DSA). Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months (mRS Score 0-2 favourable vs. 3–6 unfavourable). WFNS grad I to III were defined as good WFNS grade at admission.

Results: 106 of 125 patients were in good WFNS grade at admission (84.8%). Overall, a favourable outcome was achieved in 104 of 125 patients (83.2%). Favourable outcome was associated with younger age (54 ± 13 vs. 66 ± 11, p<0.001), good admission status (p<0.0001) and no signs of hydrocephalus (p=0.001). 73 of the 125 patients had a perimesencephalic SAH and 66 of these patients were in good condition at admission (90.4%) resulting in 64 patients with a favourable outcome (87.7%). 52 of the 125 patients had a non-perimesencephalic and non-aneurysmal SAH. 40 of these 52 patients were in good grade at admission (76.9%) and a favourable outcome was achieved in 40 patients (76.9%). In the ISAT-study, 2018 of 2143 patients were in a good grade at admission (94.2%) and a favourable outcome after 1 year was seen in 1161 of 1594 patients (72.8%). Patients with non-aneurysmal SAH achieved a better outcome than the ISAT-group (odds ratio 1.85, p=0.011 for Fisher’s exact test).

Conclusions: Non-aneurysmal SAH has a better prognosis than aneurysm-related SAH. The present data suggest that old age, poor admission status and hydrocephalus are unfavourable prognostic factors leading to a poor outcome.