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Angiogram negative subarachnoid hemorrhage

Angiogram-negative subarachnoid hemorrhage (anSAH) accounts for 15% of spontaneous subarachnoid hemorrhage SAH.

The overall incidence of true aneurysms in patients with angiogram-negative SAH is low (2.9%). Initial bleeding pattern strongly correlates with diagnostic yield and clinical outcome. Diffuse bleeding pattern is associated with significantly higher diagnostic yield, more in-hospital complications, and worse clinical outcome. Patients with initial imaging characteristics other than diffuse pattern SAH developed few disease related complications, with the majority of in-hospital adverse events treatment related 1).

Standard magnetic resonance imaging (MRI) rarely identifies the cause of hemorrhage in patients with an angiogram-negative, non perimesencephalic subarachnoid hemorrhage (SAH). Yet up to 10 % of these patients have recurrent hemorrhage

Vessel wall-MRI showed abnormalities in seven patients with angiogram-negative SAH. These findings did not alter patient management, but the findings may be useful for other physicians who choose to perform vessel wall-MRI in this patient population 2).


Low complication rate, especially in the p-SAH group 3).

Lin N, Zenonos G, Kim AH, Nalbach SV, Du R, Frerichs KU, Friedlander RM, Gormley WB. Angiogram-negative subarachnoid hemorrhage: relationship between bleeding pattern and clinical outcome. Neurocrit Care. 2012 Jun;16(3):389-98. doi: 10.1007/s12028-012-9680-6. PubMed PMID: 22350856.
Coutinho JM, Sacho RH, Schaafsma JD, Agid R, Krings T, Radovanovic I, Matouk CC, Mikulis DJ, Mandell DM. High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage. Clin Neuroradiol. 2015 Nov 25. [Epub ahead of print] PubMed PMID: 26608742.
Canneti B, Mosqueira AJ, Nombela F, Gilo F, Vivancos J. Spontaneous Subarachnoid Hemorrhage with Negative Angiography Managed in a Stroke Unit: Clinical and Prognostic Characteristics. J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2484-90. doi: 10.1016/j.jstrokecerebrovasdis.2015.06.011. Epub 2015 Sep 12. PubMed PMID: 26375795.
angiogram_negative_subarachnoid_hemorrhage.txt · Last modified: 2016/01/06 20:35 (external edit)