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Related Experiment Videos

[Subarachnoid hemorrhage without aneurysm].

W Müller-Forell1, S Welschehold, J Köhler

  • 1Institut für Neuroradiologie des Universitätsklinikums Mainz, Germany.

Der Radiologe
|November 30, 2002
PubMed
Summary
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Ruptured intracranial aneurysms cause subarachnoid hemorrhage (SAH). Even without finding an aneurysm, prognosis is better, especially with perimesencephalic patterns and good clinical condition.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Context:

  • Subarachnoid hemorrhage (SAH) is commonly caused by ruptured intracranial aneurysms.
  • A significant percentage of patients with spontaneous SAH do not have an aneurysm detected.
  • Patients without aneurysms often have a better prognosis than those with aneurysms.

Purpose:

  • To evaluate the initial CT and angiographic findings in patients with spontaneous SAH.
  • To determine factors influencing the favorable prognosis in patients with negative angiography after SAH.
  • To establish optimal diagnostic and follow-up imaging strategies for spontaneous SAH.

Summary:

  • Retrospective analysis of 773 patients with spontaneous SAH undergoing 4-vessel DSA revealed 12.4% had negative angiography.

Related Experiment Videos

  • Favorable prognosis in negative angiography cases correlated with perimesencephalic hemorrhage patterns and good initial clinical status (Hunt-Hess I/II).
  • High discharge rates without deficits were observed in patients with perimesencephalic SAH (85%) and those with intraventricular hemorrhage and good clinical condition (80%).

    • Impact:

    • Recommends obligatory 4-vessel catheter angiography (DSA) for all spontaneous SAH patients, regardless of initial CT findings.
    • Suggests a single follow-up angiography for non-perimesencephalic SAH, reserving CT angiography (CTA) for further assessments.
    • Aims to improve diagnostic accuracy and patient management in spontaneous SAH, optimizing outcomes and resource utilization.