Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Nov 2001
Diagnosis of perimesencephalic nonaneurysmal subarachnoid hemorrhage with computed tomography.
In 4% to 31% of patients with acute subarachnoid hemorrhage (SAH), no underlying cause is identified. Blood is restricted to the perimesencephalic cisterns in about two thirds of these patients. These patients are identified as having perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH), a syndrome based on the interpretation of computed tomography (CT) findings on admission, with an excellent prognosis, far better than other patients with SAH with or without an aneurysm. However, the diagnosis is subject to interrater variability, and differentiation between PNSAH and ruptured supratentorial aneurysm by means of CT has not been investigated. Therefore we investigated the validity of prediction of PNSAH with CT scan. ⋯ We conclude that PNSAH can be distinguished on CT in the majority of patients; however, the angiographical management in PNSAH should not differ from other SAHs.