{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:05:59Z","timestamp":1783073159716,"version":"3.54.6"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The rate of underlying ruptured aneurysms, complications, and their relevance to outcomes in \u201cbenign\u201d perimesencephalic subarachnoid hemorrhage are not well known and underreported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Retrospective analysis of patients with perimesencephalic subarachnoid hemorrhage from a large tertiary care center (2007\u20132022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Eighty\u2010one patients were included with mean age of 55.5\u00a0\u00b1\u00a010.3 years. An underlying ruptured aneurysm was diagnosed in 5 patients (6.2%); 3 (60%) had negative computed tomography angiography and they were detected only in digital subtraction angiography (2 on initial digital subtraction angiography and 1 on follow\u2010up digital subtraction angiography). The most common complication was vasospasm in 25\/81 patients (31%), and the majority 21\/25 (84%) were asymptomatic. Symptomatic vasospasm occurred at a significantly higher rate among patients with underlying aneurysm (40% versus 2.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01). Hydrocephalus occurred in 10% of patients, all within 1 day, but at a higher rate in the aneurysmal group (40% versus 8%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.07). A total of 88% of patients had modified Rankin scale score 0\u20132 at discharge, but at a significantly higher rate in nonaneurysmal patients (91% versus 40%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01). An underlying aneurysm, hydrocephalus, and symptomatic vasospasm were associated with poor functional status (odds ratio [OR] = 14.7 [2.1\u2013104];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.007, OR = 22.6 [4.2\u2013123.5];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001, OR = 8.6 [1.06\u201369.88];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.04), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">\u201cBenign\u201d perimesencephalic subarachnoid hemorrhage pattern was associated with a ruptured aneurysm in 6.2% of patients, and 3.7% were detected only on cerebral angiogram. Underlying aneurysm, symptomatic vasospasm, and hydrocephalus were associated with lower rates of good clinical outcome. All hydrocephalus cases were symptomatic and occurred very early. Asymptomatic vasospasm alone was not associated with poor outcomes. Our findings suggest that patients with nonaneurysmal perimesencephalic subarachnoid hemorrhage without hydrocephalus can safely be managed with less strict monitoring and a shorter hospital stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/svin.123.001166","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T04:28:06Z","timestamp":1708316886000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Aneurysmal Versus \u201cBenign\u201d Perimesencephalic Subarachnoid Hemorrhage"],"prefix":"10.1161","volume":"4","author":[{"given":"Anas","family":"Alrohimi","sequence":"first","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"},{"name":"Department of Medicine (Neurology) King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Davison","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhi","family":"Pandhi","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Abdulrazzak","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wadden","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Bain","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Moore","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Shazam","family":"Hussain","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3646-3635","authenticated-orcid":false,"given":"Gabor","family":"Toth","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Neurologic Institute Cleveland Clinic Foundation Cleveland OH United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.191395"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.9.FOCUS19653"},{"key":"e_1_3_2_4_2","first-page":"829","article-title":"Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture","volume":"12","author":"Rinkel GJ","year":"1991","unstructured":"Rinkel GJ, Wijdicks EF, Vermeulen M, Ramos LM, Tanghe HL, Hasan D, Meiners LC, van Gijn J. 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