Clinical evaluation of patients with non-aneurysmal and non-traumatic subarachnoid hemorrhage

Abstract

Background: Subarachnoid haemorrhage (SAH) accounts for about 3% of all strokes and 10% of haemorrhagic strokes, with a mortality of up to 50% of cases. In 85% of cases SAH is caused by an aneurysmal rupture, 10% – are non-aneurysmal, non-traumatic, and 5% – is due to other vascular causes. The purpose of the study was the analysis of the clinical course of patients with SAH, which was not determined by rupture of aneurysm or craniocerebral trauma. Material and methods: Patients with non-traumatic and non-aneurysmal SAH hospitalized in the Institute of Neurology and Neurosurgery between 2019 and March 2021 were collected. The diagnosis was confirmed by cerebral CT and CT angiography. Results: The study included 23 patients with non-aneurysmal, non-traumatic SAH with an average age of 59.5 years, 11 women among them. The most common risk factors were: hypertension – 20, smoking – 3, diabetes – 2, obesity – 3, dyslipidemia – 2, COVID-19 – 2, autoimmune diseases – 2. Clinical manifestations included: headache (23), nausea (13), dizziness (11), damage to the cranial nerves (6), motor deficiency (4), meningeal signs (15). Most patients had Hunt-Hess grade 2 (17/23), WFNS grade 1 (16/23), Fisher score grade 1 (13/23), mRs score 2 (17/23). Five patients were placed in the Intensive Care Unit, 5 – developed vasospasm, 2 patients – died. Conclusions: Our study found that non-aneurysmal and non-traumatic SAH developed more frequently in the elderly adults with hypertension, had moderate severity and a moderate-mild post-SAH degree of disability.