Related Experiment Video
Updated: Sep 28, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
[Subarachnoid hemorrhage without aneurysm]
W Müller-Forell1, S Welschehold, J Köhler
1Institut für Neuroradiologie des Universitätsklinikums Mainz, Germany.
Abstract:
The rupture and bleeding of intracranial aneurysms is the most common cause of a spontaneous, non-traumatic subarachnoid hemorrhage (SAH). In up to 20% of these patients, no aneurysm is found, but the prognosis of these patients is known to be better than in those with aneurysms. The retrospective evaluation of the initial CT- and angiographic findings of 773 patients with spontaneous SAH, who underwent (up to three) 4-vessel DSA, brought a percentage of 12.4% with negative angiography. We found the favourable prognosis of these patients with negative angiography not only to be dependent from the distribution of the hemorrhage, with preference to perimesencephalic pattern, but the initial clinical state. 85% of our patients, who presented with perimesencephalic blood pattern and even 80% of those patients with additional intraventricular hemorrhage but the good clinical condition of Hunt-Hess I/II were discharged without neurological deficits. We recommend the obligatory 4-vessel catheter-angiography (DSA) in all patients with spontaneous SAH, independent of the blood pattern on initial CT, and one control in the presence of other than perimesencephalic subarachnoid hemorrhage, CTA might be reserved for additional controls.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Aneurysm I: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Aneurysm III: Interprofessional Care
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Increased Intracranial Pressure l: Introduction
