Journal Article

Cerebral aneurysm exclusion by CT angiography based on subarachnoid hemorrhage pattern: a retrospective study

Maeder, Philippe, Regli, Luca, Kelliny, Marc, Binaghi, Stefano, Meuli, Reto, Levivier, Marc

2011

Overview

Background To identify patients with spontaneous subarachnoid hemorrhage for whom CT angiography alone can exclude ruptured aneurysms. Methods An observational retrospective review was carried out of all consecutive patients with non-traumatic subarachnoid hemorrhage who underwent both CT angiography and catheter angiography to exclude an aneurysm. CT angiography negative cases (no aneurysm) were classified according to their CT hemorrhage pattern as \"aneurismal\", \"perimesencephalic\" or as \"no-hemorrhage.\" Results Two hundred and forty-one patients were included. A CT angiography aneurysm detection sensitivity and specificity of 96.4% and 96.0% were observed. All 35 cases of perimesencephalic or no-hemorrhage out of 78 CT angiography negatives also had negative angiography findings. Conclusions CT angiography is self-reliant to exclude ruptured aneurysms when either a perimesencephalic hemorrhage or no-hemorrhage pattern is identified on the CT within a week of symptom onset.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Aged, 80 and over / Analysis / Aneurysm, Ruptured - diagnostic imaging / Angiography / Angiography, Digital Subtraction / Cerebral Angiography / Cerebrovascular disease and stroke / Diagnosis / Female / Humans / Intracranial Aneurysm - diagnostic imaging / Intracranial aneurysms / Male / Medicine / Medicine & Public Health / Middle Aged / Neurochemistry / Neurology / Neurosurgery / Research Article / Retrospective Studies / Subarachnoid hemorrhage / Subarachnoid Hemorrhage - diagnostic imaging