From the Research
Spontaneous non-aneurysmal subarachnoid hemorrhage (SAH) has been reported, although the provided evidence does not directly link it to diagnostic catheter cerebral angiography as a cause. The phenomenon of non-aneurysmal SAH is recognized, with studies indicating that it can occur without an identifiable source of bleeding, such as an aneurysm 1, 2, 3, 4. These studies categorize non-aneurysmal SAH into different patterns, including perimesencephalic and non-perimesencephalic, each having distinct outcomes and prognostic factors 1, 3. For instance, perimesencephalic SAH tends to have a more benign course and excellent prognosis, whereas non-perimesencephalic SAH may have more complications and a worse neurological outcome 1, 3. However, the direct association between diagnostic catheter cerebral angiography and the occurrence of spontaneous non-aneurysmal SAH is not explicitly stated in the provided evidence. Given the information available, the current evidence does not support a direct causal relationship between diagnostic catheter cerebral angiography and spontaneous non-aneurysmal subarachnoid hemorrhage. It's crucial to approach each case individually, considering the patient's overall clinical presentation, history, and the results of diagnostic imaging to determine the best course of action. In clinical practice, if a spontaneous non-aneurysmal SAH is suspected or identified, management should focus on supportive care, monitoring for potential complications such as rebleeding or hydrocephalus, and further diagnostic workup as necessary to identify any underlying cause that may require specific treatment 2, 4. The decision to perform additional diagnostic procedures, such as repeat angiography, should be based on the clinical context and the specific characteristics of the patient's SAH, as outlined in studies discussing the management of non-aneurysmal SAH 2.