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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.
GLOSSARY
- CI=
- confidence interval;
- DSA=
- digital subtraction angiography;
- LP=
- lumbar puncture;
- NPSAH=
- nonperimesencephalic subarachnoid hemorrhage;
- SAH=
- subarachnoid hemorrhage
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received September 7, 2014.
- Accepted in final form December 15, 2014.
- © 2015 American Academy of Neurology
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