DSA negative subarachnoid hemorrhage:a clinical analysis of 39 cases

Objective To analyze the clinical features of patients with subarachnoid hemorrhage (SAH) presenting negative digital subtraction angiography(DSA) and the differences of diagnosis and prognosis innegative patients between penmesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) and non-PNSAH.Methods Thirty nine DSA-negative SAH patients were enrolled in the study,including 27 patients with penmesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) and 12 non-PNSAH patients.The clinical data including mean age,Hunt-Hess grade at admission,complications,prognosis on discharge and history of hypertension were analyzed retrospectively.Results There was no significant difference in mean age,Hunt-Hess grade at admission and history of hypertension between the two groups.The complication rate in non-PNSAH group was significantly higher than that in PNSAH(χ~2 = 19.195,P=0.000).Except one fatal case and one died,one mild disability case other 37 patients had good prognosis.Conclusion DSA- negative SAH patients with non-PNSAH have risk of condition deteriorated after complications;for them DSA should be repeated;if DSA is still negative,MRA or CTA examination may be followed.