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Abstract - Original Article

J Cerebrovasc Endovasc Neurosurg. 2022 24(3): 232-240
The Journal of Cerebrovascular and Endovascular Neurosurgery
      
 
The relationship between non-aneurysmal spontaneous subarachnoid hemorrhage and basilar tip anatomy
Hangeul Park1, Young-Je Son1,2, Noah Hong1, Seung Bin Kim3
1Department of Neurosurgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea 2Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea 3Intensive Care Units, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea

Objective: Non-aneurysmal spontaneous subarachnoid hemorrhage (NASAH) has a good prognosis, but its cause has not been clearly identified. In this study, we assessed the clinical and radiological features of NASAH and suggested an anatomical relationship between the basilar tip anatomy and NASAH. Methods: From August 2013 to May 2020, 21 patients were diagnosed with NASAH at our institution. We evaluated the clinical features of NASAH. NASAH was classified into a perimesencephalic pattern and aneurysmal pattern according to the distribution of hemorrhage based on initial brain computed tomography. Digital subtraction angiography was used to classify the basilar tip anatomy into symmetric cranial fusion, symmetric caudal fusion, or asymmetric fusion types. Results: Of the 21 patients, twenty patients had a good clinical outcome (modified Rankin Scale (mRS) 1–2; Glasgow Outcome Scale (GOS) 4–5). These patients showed improvement in mRS and Glasgow Coma Scale (GCS) at the last follow-up (P=.003 and P=.016, respectively). Eighteen patients with NASAH (85.7%) had the caudal fusion type, and only three patients with NASAH (14.3%) had the cranial fusion type. Seven patients with the perimesencephalic pattern (77.8%) had the caudal fusion type, and eleven patients with the aneurysmal pattern (91.7%) had the caudal fusion type. Conclusions: In NASAH patients, the caudal fusion tends to occur frequently among patients with basilar tip anatomy. In the case of the caudal fusion, the perforators around the basilar tip would be more susceptible to hemodynamic stress, which could contribute to the occurrence of NASAH.
 
Key words : Non-aneurysmal, Spontaneous, Subarachnoid hemorrhage, Basilar tip, Anatomy
 
 
    
 
 
 

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