Value of MRI Spine in the Diagnostic Workup of Non-Traumatic Non-Aneurysm Subarachnoid Hemorrhage (SAH)

Abstract

Background: There is disagreement over the best way to diagnose non-traumatic angiographically negative subarachnoid haemorrhage (AN-SAH).

Objective: This study aimed to evaluate the added value of spine MRI in identifying causes of non-traumatic, non-ANSAH.

Methods: This retrospective study analyzed 86 consecutive patients, all aged 18 years or older, who were diagnosed with non-traumatic  SAH and had negative results on cerebrovascular catheter angiography. Following this, spinal magnetic resonance imaging (MRI) was  performed for each patient. Two physicians, who were blinded to the study, independently reviewed all the MRI scans. The study aimed  to determine the diagnostic utility of spina l MRI in these cases.

Results: The comprised subjects' mean age was 52 ± 2.83 years. There  were 50 (58.14%) male patients and 36 female patients. There were no patients with any family history. The median value of WFNs was 1  with an IQR of 1-1.75, that of Hunt, and Hess (H & H) classification was 1 with an IQR of 1-2, and that of GSC was 15 with an IQR of 14-15.  Out of 86 patients with SAH that underwent MRI, only one patient was detected to have cervical abnormality by MRI.

Conclusion: In  scenarios devoid of clinical or neurological indicators that would imply a spinal pathology, the employment of spinal MRI subsequent to  AN-SAH demonstrated a markedly diminished diagnostic efficacy. Consequently, the habitual utilization of MRI to ascertain potential  spinal origins of intracranial AN-SAH lacks substantiation from an evidence-based perspective.