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Long-term outcome and quality of life after nonaneurysmal subarachnoid hemorrhage

  • Clinical Article
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Abstract

Purpose

Nonaneurysmal subarachnoid hemorrhage (SAH) is an uncommon form of SAH. As nonaneurysmal SAH is often concentrated around the pons and midbrain, the term perimesencephalic SAH (pmSAH) is widely accepted to describe this entity, though there are patients with a more widespread distribution of subarachnoid blood (non-pmSAH). The outcome of pmSAH is commonly regarded as good, although often outcome is not analyzed using standardized tools of outcome measurement. In this study we focused on the patient’s quality of life after nonaneurysmal SAH.

Methods

We included 26 patients in this study who experienced a nonaneurysmal SAH between 2003 and 2007. Neurological status upon admission as well as on discharge was recorded. All patients received a detailed postal questionnaire on their current neurological situation, dependence on care (Barthel Index), quality of life regarding their physical and psycho-social well-being (Short-form 36) and current employment situation and ability to work, respectively.

Results

After 32.68 ± 19.81 months, almost all patients achieved a Glasgow Outcome Score of 4 or 5 and a Barthel Index of more than 90, although there was a difference between patients suffering from pmSAH and patients with non-pmSAH. Physical and social functioning recovered to almost normal levels but vitality and individual health were often perceived as reduced in self-evaluation.

Conclusion

Nonaneurysmal SAH is a begnin entity, though there is a difference between pmSAH and non-pmSAH in outcome. Self-evaluations of vitality and individual health in both groups are often experienced as reduced, thus imposing the question of whether neurological rehabilitation should be recommended despite good neurological outcome.

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Authors and Affiliations

  1. Department of Neurosurgery, Heinrich-Heine-University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany

    Kerim Beseoglu, Silke Pannes, Hans J. Steiger & Daniel Hänggi

Authors
  1. Kerim Beseoglu
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  2. Silke Pannes
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  3. Hans J. Steiger
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  4. Daniel Hänggi
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Corresponding author

Correspondence to Kerim Beseoglu.

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Comment

This article addresses the outcome of patients with non-aneurysmal SAH (naSAH). Three distinct groups are created according to the distribution of blood along the cisterns and also within the ventricles. Not surprisingly and in  keeping with other reports on this subject, patients with pmSAH fared better and had a shorter hospital stay than those with nonpmSAH or with IVH + pmSAH. The fact that the analysis is based on a single questionnaire launched within a time frame with considerable variation is one weak spot. Also, the number of answers registered in each subgroup may influence the results in a series with these limited numbers.

Manuel Cunha e Sa

Almada, Portugal

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Beseoglu, K., Pannes, S., Steiger, H.J. et al. Long-term outcome and quality of life after nonaneurysmal subarachnoid hemorrhage. Acta Neurochir 152, 409–416 (2010). https://doi.org/10.1007/s00701-009-0518-8

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  • DOI: https://doi.org/10.1007/s00701-009-0518-8

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