Yield of spinal imaging in nonaneurysmal, nonperimesencephalic subarachnoid hemorrhage

Menno R Germans, Bert A Coert, Charles B L M Majoie, René van den Berg, Geert Lycklama À Nijeholt, Gabriël J E Rinkel, Dagmar Verbaan, W Peter Vandertop

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Abstract

OBJECTIVE: We studied the yield of MRI of the spinal neuraxis in patients with nonperimesencephalic subarachnoid hemorrhage (NPSAH).

METHODS: In a prospective, multicenter study, we performed T1-weighted and T2-weighted MRI of the spinal axis in a consecutive series of patients with a spontaneous NPSAH without intracranial vascular pathology on intracranial vascular imaging.

RESULTS: A spinal origin of the hemorrhage was found in 3 of 75 patients (4%; 95% confidence interval 0-8.4). The lesions were 1 lumbar ependymoma and 2 cervical cavernous malformations. All 3 patients presented without focal neurologic deficits and 2 had a CT-negative subarachnoid hemorrhage but positive lumbar puncture. Patients with a spinal origin were younger than patients without a spinal origin (38 vs 56 years; p < 0.05), which was the only significant difference between groups.

CONCLUSIONS: The yield and clinical relevance of MRI of the spinal axis in patients who present with NPSAH is low. We do not recommend routine MRI of the spinal axis in this patient population, but it might be justified in a subgroup of patients.

Original languageEnglish
Pages (from-to)1337-40
Number of pages4
JournalNeurology
Volume84
Issue number13
DOIs
Publication statusPublished - 31 Mar 2015

Cite this

Germans, M. R., Coert, B. A., Majoie, C. B. L. M., van den Berg, R., Lycklama À Nijeholt, G., Rinkel, G. J. E., ... Vandertop, W. P. (2015). Yield of spinal imaging in nonaneurysmal, nonperimesencephalic subarachnoid hemorrhage. Neurology, 84(13), 1337-40. https://doi.org/10.1212/WNL.0000000000001423