SynthesisActa neurochirurgica2019
Subarachnoid haemorrhage with negative initial neurovascular imaging: a systematic review and meta-analysis.
Synthesis in Acta neurochirurgica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Angiography-Negative Subarachnoid Hemorrhage Detected After Emergent Percutaneous Coronary Intervention for Non-ST-Segment Elevation Myocardial Infarction: A Case Report.Clinical case reports · 2026Article
- Stretching the Limits: A Rare Case Report of Perimesencephalic Subarachnoid Hemorrhage During Yoga.Clinical practice and cases in emergency medicine · 2026Article
- Delayed identification and treatment of a cervicomedullary spinal vascular lesion following angiogram-negative, high-grade subarachnoid hemorrhage: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Frailty diminishes functional outcome in patients with nonaneurysmal subarachnoid hemorrhage: a dual specialized neurovascular center analysis.Journal of neurology · 2025Article
- Ruptured Basilar Artery Perforator Aneurysm: Nightmare of a Treating Neurosurgeon.Asian journal of neurosurgery · 2025Article
- Benign versus sinister aetiologies underlying basal cistern subarachnoid haemorrhage: a case series.Journal of medical case reports · 2025Article
- Perimesencephalic Hemorrhagic-Pontine Infarction Syndrome: Miler Fisher's Hint to Subarachnoid Paramedian Artery Rupture-A Case Report.Case reports in neurological medicine · 2025Article
- Risk stratification of delayed causative aneurysm detection and long-term outcome in angiographically negative spontaneous subarachnoid haemorrhage.Stroke and vascular neurology · 2024Article
- The value of modified hijdra score in patients with aneurysmal subarachnoid hemorrhage.Heliyon · 2024Article
- Comment on Roman-Filip et al. Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: A Literature Review.Diagnostics (Basel, Switzerland) · 2023Article
- Endovascular Embolization with n-Butyl Cyanoacrylate for Ruptured Distal Posterior Inferior Cerebellar Artery Dissecting Aneurysm.Asian journal of neurosurgery · 2023Article
- The Diagnostic Dilemma in Delayed Subarachnoid Hemorrhage: A Case Report.Clinical practice and cases in emergency medicine · 2023Article
- Lumbar puncture-verified subarachnoid hemorrhage: bleeding sources, need of radiological examination, and functional recovery.Acta neurochirurgica · 2023Article
- Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: A Literature Review.Diagnostics (Basel, Switzerland) · 2023Review
- Cost-effectiveness of repeat delayed imaging for spontaneous subarachnoid hemorrhage.PloS one · 2023Article
- Spontaneous subarachnoid haemorrhage.Lancet (London, England) · 2022Review
- Angiographically Occult Subarachnoid Hemorrhage: Yield of Repeat Angiography, Influence of Initial CT Bleed Pattern, and Sources of Diagnostic Error in 242 Consecutive Patients.AJNR. American journal of neuroradiology · 2022Article
- A giant basilar artery perforator aneurysm.Radiology case reports · 2022Article
- The Value of the Correlation Coefficient Between the ICP Wave Amplitude and the Mean ICP Level (RAP) Combined With the Resistance to CSF Outflow (Rout) for Early Prediction of the Outcome Before Shunting in Posttraumatic Hydrocephalus.Frontiers in neurology · 2022Article
- Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin.Journal of inflammation research · 2022Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with spontaneous subarachnoid haemorrhage (SAH), a vascular cause for the bleed is not always found on initial investigations. This study aimed to systematically evaluate the delayed investigation strategies and clinical outcomes in these cases, often described as "non-aneurysmal" SAH (naSAH).
methodsA systematic review was performed in concordance with the PRISMA checklist. Pooled proportions of primary outcome measures were estimated using a random-effects model.
resultsFifty-eight studies were included (4473 patients). The cohort was split into perimesencephalic naSAH (PnaSAH) (49.9%), non-PnaSAH (44.7%) and radiologically negative SAH identified on lumbar puncture (5.4%). The commonest initial vascular imaging modality was digital subtraction angiography. A vascular abnormality was identified during delayed investigation in 3.9% [95% CI 1.9-6.6]. There was no uniform strategy for the timing or modality of delayed investigations. The pooled proportion of a favourable modified Rankin scale outcome (0-2) at 3-6 months following diagnosis was 92.0% [95% CI 86.0-96.5]. Complications included re-bleeding (3.1% [95% CI 1.5-5.2]), hydrocephalus (16.0% [95% CI 11.2-21.4]), vasospasm (9.6% [95% CI 6.5-13.3]) and seizure (3.5% [95% CI 1.7-5.8]). Stratified by bleeding pattern, we demonstrate a higher rate of delayed diagnoses (13.6% [95% CI 7.4-21.3]), lower proportion of favourable functional outcome (87.2% [95% CI 80.1-92.9]) and higher risk of complications for non-PnaSAH patients.
conclusionThis study highlights the heterogeneity in delayed investigations and outcomes for patients with naSAH, which may be influenced by the initial pattern of bleeding. Further multi-centre prospective studies are required to clarify optimal tailored management strategies for this heterogeneous group of patients.
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