Neurosurgical Review

, 34:477 | Cite as

Subarachnoid hemorrhage and negative angiography: clinical course and long-term follow-up

  • Marco Fontanella
  • Innocenzo Rainero
  • Pier Paolo Panciani
  • Bawarjan Schatlo
  • Chiara Benevello
  • Diego Garbossa
  • Christian Carlino
  • Walter Valfrè
  • Federico Griva
  • Gianni Boris Bradac
  • Alessandro Ducati
Original Article


The aim of this study was to investigate the long-term natural history of nontraumatic angiogram-negative subarachnoid hemorrhage with typical pretruncal (P-SAH) and diffuse (D-SAH) pattern of hemorrhage. A retrospective review of 102 patients who experienced angiographically negative SAH at our institution was undertaken (11.6% of 882 spontaneous SAH). Follow-ups were obtained at 7.9 to 16 years. In the D-SAH group, 11 patients (13.9%) out of 79 had an aneurysm, and four (5.1%) had rebleeding episodes. In the P-SAH group, the second angiography was negative in all of the 23 cases, and no rebleeding episodes were recorded. The long-term follow-up confirms that P-SAH is a benign disease. A second angiography could not be necessary. D-SAH is probably due to an aneurysm that thrombose early after the bleeding. At short-term follow-up, the sack could frequently recanalize and rebleed, whereas a late follow-up shows that rebleeding is very rare.


Negative angiography Pretruncal subarachnoid hemorrhage Intracranial aneurysms Subarachnoid hemorrhage of unknown cause Angiogram-negative subarachnoid hemorrhage 



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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Marco Fontanella
    • 1
  • Innocenzo Rainero
    • 2
  • Pier Paolo Panciani
    • 1
  • Bawarjan Schatlo
    • 3
  • Chiara Benevello
    • 1
  • Diego Garbossa
    • 1
  • Christian Carlino
    • 1
  • Walter Valfrè
    • 2
  • Federico Griva
    • 1
  • Gianni Boris Bradac
    • 4
  • Alessandro Ducati
    • 1
  1. 1.Division of Neurosurgery, Department of NeuroscienceUniversity of TorinoTorinoItaly
  2. 2.Division of Neurology, Department of NeuroscienceUniversity of TorinoTorinoItaly
  3. 3.Department of NeurosurgeryUniversity Hospital GenevaGenevaSwitzerland
  4. 4.Division of Neuroradiology, Department of NeuroscienceUniversity of TorinoTorinoItaly

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