Journal article
Spontaneous isolated convexity subarachnoid hemorrhage: presentation, radiological findings, differential diagnosis, and clinical course: Clinical article
Journal of neurosurgery, Vol.109(6), pp.1034-1041
12/2008
DOI: 10.3171/JNS.2008.109.12.1034
PMID: 19035716
Abstract
Object The clinical characteristics and overall outcome in patients with spontaneous isolated convexity subarachnoid hemorrhage (SAH) are not well described in the literature. The purpose of this study was to examine the mode of presentation, common origins, radiographic findings, and clinical course in a large case series of such patients. Methods A retrospective single-center chart review of all patients in whom nontraumatic primary convexity SAH was diagnosed between 2002 and 2007 was performed. Twenty patients were identified and analyzed for presenting symptoms, radiological and laboratory findings, hospital course, and outcome. Results There were 15 women and 5 men in our series, and the mean age was 52 years (range 18–86 years). The most common presenting symptom was headache, with 15 patients experiencing it as a chief complaint. Other frequent manifestations included altered mental status (8 patients), focal neurological deficits (7), and seizure (4 patients). An underlying cause of the hemorrhage was identified in 13 cases, whereas the remainder went unresolved. Of the known causes, 5 were due to posterior reversible encephalopathy syndrome, 3 were caused by thrombocytopenia or anticoagulation, and the remainder were isolated cases of lupus vasculitis, drug-induced vasculopathy, postpartum cerebral angiopathy, hypertensive microangiopathy, and Call–Fleming syndrome. All patients with unknown disease origins had favorable outcomes, whereas 8 of 13 patients with an identifiable underlying disorder experienced favorable outcomes. Conclusions Spontaneous isolated convexity SAH is rarely caused by aneurysm rupture, has a distinct mode of presentation, and generally carries a more favorable prognosis than that of aneurysmal SAH.
Details
- Title: Subtitle
- Spontaneous isolated convexity subarachnoid hemorrhage: presentation, radiological findings, differential diagnosis, and clinical course: Clinical article
- Creators
- Daniel Refai - 1Department of NeurosurgeryJames A Botros - 1Department of NeurosurgeryRussell G Strom - 1Department of NeurosurgeryColin P Derdeyn - 1Department of Neurosurgery,, 2Mallinckrodt Institute of Radiology, and, 3Department of Neurology, Washington University School of Medicine, Saint Louis, MissouriAseem Sharma - 2Mallinckrodt Institute of Radiology, andGregory J Zipfel - 1Department of Neurosurgery,, 3Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.109(6), pp.1034-1041
- DOI
- 10.3171/JNS.2008.109.12.1034
- PMID
- 19035716
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 12/2008
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020604102771
Metrics
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