Nonaneurysmal Subarachnoid Hemorrhage: A Review of Clinical Course and Outcome in Two Hemorrhage Patterns

Linda L. Herrmann; Joseph M. Zabramski


J Neurosci Nurs. 2007;39(6):135-142. 

In This Article


These two case studies demonstrate the differences in clinical presentation and management of patients with the perimesencephalic distribution of SAH compared to those with the aneurysmal pattern of SAH. The first case illustrates the benign clinical course reported for the perimesencephalic pattern of hemorrhage as well as the fact that repeat angiography is seldom needed. The second case demonstrates the more complicated clinical course seen in patients with an aneurysmal pattern of hemorrhage, which may include hydrocephalus and vasospasm. Patients with this latter pattern of hemorrhage require invasive monitoring, astute nursing care, and repeat angiography to exclude an aneurysm. The key to management of these patients is the severity and distribution of blood on the initial CT scan.