Perimesencephalic subarachnoid hemorrhage: Etiologies, risk factors, and necessity of the second angiogram

• Published in: Asian journal of neurosurgery 2016-01, Vol.11 (1), p.50-53
• Main Authors: Sahin, Soner, Delen, Emre, Korfali, Ender
• Format: Article
• Language: English
• Subjects: Angiography; Care and treatment; Complications and side effects; Development and progression; Original; ORIGINAL ARTICLE; Risk factors; Stroke; Subarachnoid hemorrhage
• ISSN: 1793-5482; 2248-9614
• DOI: 10.4103/1793-5482.165793

Aim: In this paper, we aim to present our experience with a series of patients with PMSAH. In addition, the clinical course of perimesencephalic subarachnoid hemorrgade (PMSAH) is discussed with an evaluation of etiologies, risk factors, and the necessity for a second angiogram on follow-up. Materials and Methods: The data for this study were obtained retrospectively from patients who were treated at the Uludag University, School of Medicine, Department of Neurosurgery, Division of Neurovascular Surgery's clinic with a diagnosis of PMSAH between January 1980 and March 2002. Results: We identified a total of 24 patients, 12 male. The mean age at the time of hemorrhage was 53 ± 12 years. In all patients, the onset was typical with a sudden severe headache. Five of the patients were Hunt-Hess Grade I, 15 were Grade II, and 4 were Grade III. The initial 4-vessel angiography was normal in 23 cases. Twenty-two had a second 4-vessel angiography, and all were normal. We observed acute hydrocephalus in 5 patients (20.8%). We did not observe re-bleeding during the follow-up of our patients. Conclusion: Patients with PMSAH have a particularly excellent outcome, and there is no need to evaluate these patients with repeat angiography.