Etiological diagnosis of spontaneous subarachnoid hemorrhage:analysis of 1550 cases

Objective To explore the etiology and diagnosis of spontaneous subarachnoid hemorrhage(SAH).Methods Etiological factors of SAH were summarized retrospectively, emphasizing the analysis of clinical data in the recent three years in 1 550 patients.Results Intracranial aneurysm was the main etiological factor, accounting for 71.35%(1 106 cases) in SAH.Intracranial AVM(63 cases), DAVF(56 cases) and moyamoya disease or moyamoya syndrome(41 cases) accounted for 4.06%, 3.61%, 2.65%, respectively.Furthermore, other diseases accounted for 1.61%(25 cases).Two hundred and fifty nine cases(16.71%) were unidentified in initial DSA examination.Second angiography was negative in all patient with perimesencephalic subarachnoid hemorrhage(PNSAH).The adverse reaction rate of DSA was 1.06%, and no statistical significance in difference between different time points of DSA after SAH(P0.05).The coincidence rate between CTA and DSA was 84.13%.Conclusions The causes of SAH are complicated and variable, and proper therapeutic strategy should be applied for each patient.The adverse reaction rate of cerebral angiography is low.It is valuable to perform the second cerebral angiography for those unidentified in first angiography.The etiological diagnosis of SAH by DSA is better than CTA.