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[Cerebral computer tomography in subarachnoid hemorrhage]
Audun E Berstad1, Siri Hylleraas Bø, Ove Sortland
1Radiologisk avdeling, Akershus universitetssykehus 1474 Nordbyhagen. audun.berstad@rh.uio.no
Summary
A cerebral CT scan is 91% accurate for diagnosing subarachnoid hemorrhage. If CT scans are normal but suspicion remains high, a lumbar puncture is recommended to confirm diagnosis.
Area of Science:
- Neurology
- Radiology
- Emergency Medicine
Background:
- Cerebral CT scans are standard for subarachnoid hemorrhage evaluation.
- The diagnostic accuracy and clinical value of initial CT scans require further establishment.
Purpose of the Study:
- To evaluate the accuracy and utility of initial cerebral CT scans in diagnosing subarachnoid hemorrhage.
Main Methods:
- Retrospective review of initial CT scans from 70 patients with subarachnoid hemorrhage.
- Independent evaluation by two observers for the presence of blood in cerebrospinal fluid spaces.
Main Results:
- CT scans detected blood in 91% of patients, most commonly in basal cisterns, Sylvian Fissure, and cortical sulci.
- Raised intracranial pressure was noted in 41% of cases.
- Lumbar puncture confirmed subarachnoid hemorrhage in all patients with initially normal CT scans.
Conclusions:
- A normal cerebral CT scan does not exclude subarachnoid hemorrhage.
- Lumbar puncture is crucial for diagnosis when CT is negative but clinical suspicion for subarachnoid hemorrhage persists.