Risk factors, clinical course and prognosis of patients with non-aneurysmal and non-traumatic subarachnoid hemorrhage

Abstract

Subarachnoid hemorrhage (SAH) accounts for about 2-7% of all strokes. In 85% cases SAH is caused by an aneurysmal rupture, 10% of SAH are non-aneurysmal, non-traumatic, and 5% of SAH is due to other causes. The risk factors with a major resonance are arterial hypertension and smoking. The purpose of the study was the analysis of the risk factors, clinical course and prognosis in patients with SAH, which was not determined by the rupture of aneurysm or craniocerebral trauma. Methods: The patients were collected during the hospitalization in the Institute of Neurology and Neurosurgery “Diomid Gherman” between 2019 and March 2021. The diagnosis was confirmed by brain CT, CT angiography and cerebral MRI. In this study, for the clinical, paraclinical evaluation and prognostic were used the Hunt-Hess, WFNS, mFisher, mRankin scales. Results: The average age of the 23 research patients is 59,85 years old. Risk factors were assessed: hypertension – 20, smoking – 3, diabetes – 2, obesity – 3, dyslipidemia–2, COVID-19 – 2, autoimmune diseases – 2. The patient’s prognosis was determined according to the scales (medial score): Hunt-Hess grade 2 (2,39), WFNS grade 1-2 (1,78), mFisher grade 1-2 (1,82), mRankin score 1-2 (1,73), 5 patients – developed vasospasm, 2 patients – died. Conclusions: SAH non-aneurysm and non-traumatic, has an almost equal gender distribution, has developed in middleaged adult, the most common risk factor being arterial hypertension. Compared to women, men with non-anevrismal and non-traumatic SAH presented several associated risk factors, but at the same time they had good clinical results, low complication rates and favorable prognosis.