Objective Spontenous cerebral convexal subarachnoid hemorrhage (cSAH) is different from aneurysmal subarachnoid hemorrhage (aSAH). This study was to describe the clinical and vascular imaging characteristics and discuss the potential causes of cSAH.
Methods We retrospectively selected patients admitted to Department of Neurology of Beijing Tiantan Hospital, from Dec. 2001 to Jan. 2013, who presented with cSAH. Data of demographic characteristics, clinical presentations and cerebrovascular imaging were collected.
Results Fifty-four patients (34 men and 20 women) were included. Median age was 58.5 years (interquartile range 48.8~70.8). Prevalences of risk factors for cerebrovascular disease were as follows:dyslipidemia (n=23, 42.6%), hypertension (n=21, 38.9%), diabetes mellitus (n=11, 20.4%), smoking (n=8, 14.8%).Thirty-seven patients was admitted to the hospital, in whom the frequencies of symptoms were as follows:headache (n=14, 37.8%), weakness (n=13, 35.1%), numbness (n=8, 21.6%), dysarthria (n=8, 21.6%). The symptoms were transient (n=16, 43.2%) or persistent (n=23, 56.8%). computed tomography (CT) or magnetic resonance imaging (MRI) showed that hemorrhage mostly located in or near the central sulcus. Cerebral angiography was performed in 39 patients. The most common vascular abnormalities were isolateral internal carotid artery or middle cerebral artery stenosis or occlusion (n=23). No aneurysm was found in the field of cSAH.Patients >50 years old (n=30, 76.9%) are more than patients 50 years (n=9, 23.1%).In the 30 patients >50 years, cerebral artery stenosis or occlusion is in the highest proportion in a variety of causes (66.7%). While in the 9 patients 50 years old, cerebral artery stenosis or occlusion is rare (33.3%). On the number and proportion of cerebral artery stenosis or occlusion, male (n=18, 69.2%) is than female (n=5, 38.5%).
Conclusion Cerebrovascular stenosis or occlusion may be the main cause of cSAH.
