Low Diagnostic Yield of Non-Invasive Imaging In Angiogram-Negative Subarachnoid Hemorrhage

Objectives: We describe the application of fundamental quality improvement methods to medical handoffs in order to improve resident learning and clinical training.Methods: We retrospectively reviewed 226 non-traumatic SAH patients admitted to our institution from January 1, 2007 to June 1, 2009. Imaging data were abstracted from medical charts.Results: Of the 226 SAH patients, 45 (19.9%) had no aneurysm on initial angiography. Of these angiogram-negative SAH patients, 12 (26.7%) were perimesencephalic SAH and 33 (73.3%) were NPAN-SAH. An average of 3.2 non-invasive studies was performed on each patient. In these 142 additional non-invasive studies, there was no additional diagnostic yield in finding the source of SAH.Conclusions: Though non-perimesencephalic angiogram-negative SAH had a worse prognosis compared to perimesencephalic SAH, additional non-invasive neuroimaging provided no diagnostic yield in either patient population.