Long-term outcome and quality of life after nonaneurysmal subarachnoid hemorrhage.

Abstract

Nonaneurysmal subarachnoid hemorrhage (SAH) is an uncommon form of SAH. As nonaneurysmal SAH is often concentrated around the pons and midbrain, the term perimesencephalic SAH (pmSAH) is widely accepted to describe this entity, though there are patients with a more widespread distribution of subarachnoid blood (non-pmSAH). The outcome of pmSAH is commonly regarded as good, although often outcome is not analyzed using standardized tools of outcome measurement. In this study we focused on the patient's quality of life after nonaneurysmal SAH. We included 26 patients in this study who experienced a nonaneurysmal SAH between 2003 and 2007. Neurological status upon admission as well as on discharge was recorded. All patients received a detailed postal questionnaire on their current neurological situation, dependence on care (Barthel Index), quality of life regarding their physical and psycho-social well-being (Short-form 36) and current employment situation and ability to work, respectively. After 32.68 +/- 19.81 months, almost all patients achieved a Glasgow Outcome Score of 4 or 5 and a Barthel Index of more than 90, although there was a difference between patients suffering from pmSAH and patients with non-pmSAH. Physical and social functioning recovered to almost normal levels but vitality and individual health were often perceived as reduced in self-evaluation. Nonaneurysmal SAH is a begnin entity, though there is a difference between pmSAH and non-pmSAH in outcome. Self-evaluations of vitality and individual health in both groups are often experienced as reduced, thus imposing the question of whether neurological rehabilitation should be recommended despite good neurological outcome.