Evaluation of angiographically negative spontaneous subarachnoid hemorrhage

Objective of the study was to review patients with angiographically negative spontaneous subarachnoid hemorrhage (SAH) and to compare with aneurysmal SAH, as well as to discuss, which patients need repeat-angiography and what imaging method should be used. Materials and methods. All patients, who were admitted to Department of Neuroangiosurgery of Kaunas University Hospital after spontaneous SAH in 1994–2000 were evaluated. Neurological status, complications, outcome, radiological findings were investigated and evaluated. Results. Study showed that the main reason of spontaneous SAH is ruptured intracranial aneurysm. Rare causes of SAH are also possible; also ones of unknown ethiology. It was found that patients with angiographically negative SAH were in better neurological status, had a small number of complications and better outcome. It was discussed, which patients nead repeat-angiography and what method of imaging should be used. Conclusions. Angiograhically negative SAH course is better than aneurysmal SAH; not all patients need angiography to be repeated. It is proposed to perform angiography in the group of patients with increased risk