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Outcome in perimesencephalic (nonaneurysmal) subarachnoid hemorrhage

A follow-up study in 37 patients

From University Department of Neurology (Drs. Rinkel, Wijdicks, and van Gijn), Utrecht; University Department of Neurology (Dr. Vermeulen), Rotterdam, University Department of Neurosurgery (Dr. Hageman), Amsterdam; and Neurology Department (Dr. Tans), Westeinde Hospital, The Hague, The Netherlands.

We interviewed 37 patients with perimesencephalic hemorrhage, 18 months to 7 years after the bleed. None rebled or had persisting neurologic deficits. These findings are remarkably good compared with recent series of patients with subarachnoid hemorrhage and normal angiogram. When blood is confined to the mesencephalic cisterns in patients with normal angiogram, repeat angiography may not be indicated.

Address correspondence and reprint requests to Dr. Gabriël J.E. Rinkel, University department of Neurology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Presented in part at the 42nd annual meeting of the American Academy of Neurology, Miami Beach, FL, May 1990.

Received October 6, 1989. Accepted for publication in final form December 13, 1989.

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