Epidemiological, Clinical, Paraclinical, and Evolutionary Characteristics of Non-Traumatic Subarachnoid Hemorrhage in Intensive Care Units in Libreville

Objective: The study aimed to describe the epidemiological, clinical, and paraclinical aspects of severe non-traumatic meningeal hemorrhage in the intensive care units of the Libreville and Owendo University Hospital Centers. Materials and Methods: This is a cross-sectional, descriptive, and retrospective study from January 1, 2017, to December 31, 2024. The patients included were over 16 years old and hospitalized for non-traumatic subarachnoid hemorrhage. Results: Overall, meningeal hemorrhage accounted for 11.72% of strokes in the intensive care unit. The average age of the patients was 46.61 ± 11.59 years with a sex ratio of 0.43. Hypertension, alcohol, and tobacco were the risk factors identified. A severe consciousness disorder was present in 40% of cases and hemodynamic instability was present in 82%. Meningeal syndrome was found in 27% of patients, and motor deficits were associated in 48%. Brain CT scans were performed within 24 hours in 67% of cases. The severity scores WFNS and modified FISHER showed that 55% and 52% of patients, respectively, were classified as grade IV. The mortality rate was 67%. Conclusion: Non-traumatic subarachnoid hemorrhage has a low prevalence in intensive care and affects young adults. Clinical manifestations are dominated by consciousness disorders. Ventricular flooding is often associated.