Yield of spinal imaging in nonaneurysmal, nonperimesencephalic subarachnoid hemorrhage

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Title:	Yield of spinal imaging in nonaneurysmal, nonperimesencephalic subarachnoid hemorrhage
Author(s):	Germans, M.R.; Coert, B.A.; Majoie, C.B.; Berg, R. van den; Lycklama, A.N.G.; Rinkel, G.J.; Verbaan, D.; Vandertop, W.P.
Publication year:	2015
Source:	Neurology, vol. 84, iss. 13, (2015), pp. 1337-1340
ISSN:	0028-3878
DOI:	https://doi.org/10.1212/WNL.0000000000001423
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/154474
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Subject:	Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences
Organization:	Neurosurgery
Journal title:	Neurology
Volume:	vol. 84
Issue:	iss. 13
Page start:	p. 1337
Page end:	p. 1340
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.