Clinical Features Of The Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage: 35 Cased Report

Objective: To analysis clinical manifestations and imaging features of perimesencephalic nonaneurysmal subarachnoid hemorrhage.Methods: Clinical data of 35 cases with perimesencephalic nonaneurysmal subarachnoid hemorrhage was collected in this study. All cases were admitted to the Department of Neurology, the Second Affiliated Hospital of Dalian Medical University, from January 2001 to June 2010. The clinical manifestations, imaging features and prognosis, were retrospectively investigated and concluded.Results:1. Clinical symptoms are mild in these cases with Hunt-Hess grade—Ⅱ, with no consciousness disturbance and focal neurological deficits and hydrocephalus, with few cerebral vasospasm cases which recovered faster by symptomatic treatment.2. CT showed that the blood mainly distributed in mesencephalon surrounding cisterna and anterior pons pool. The blood spreaded into the cerebral longitudinal fissure and fissure of Sylvius in few cases (5.71%, 2/35). Most CT images were classified into Fisher Grade 1~2, 2 cases were Grade 3, no Grade 4 case. All cases had a negative DSA examination performed within one week after onset, and repeated DSA showed no abnormality in 3 months of onset.3. Average hospitalization duration was 16 days. After a mean 14 months follow-up, there was no re-bleeding and permanent nerve dysfunction.Conclusion: There is no positive finding by DSA examination in perimesencephalic nonaneurysmal subarachnoid hemorrhage. The clinical symptoms are mild. All patients recovered fast with few complications and good prognosis. There was no obvious effect for the future quality of life.