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Related Experiment Videos

Bleeding patterns in ruptured posterior fossa aneurysms: a CT study.

N Sadato1, Y Numaguchi, D Rigamonti

  • 1Department of Diagnostic Radiology, University of Maryland Medical System, Baltimore 21201.

Journal of Computer Assisted Tomography
|July 1, 1991
PubMed
Summary
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Computed tomography reveals that acute posterior fossa aneurysm rupture frequently causes extravasated blood and intraventricular hemorrhage (IVH). This imaging pattern aids in diagnosing ruptured posterior fossa aneurysms, distinguishing them from supratentorial cases.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Posterior fossa aneurysms are a significant cause of subarachnoid hemorrhage (SAH).
  • Distinguishing the source of hemorrhage in the posterior fossa can be challenging.
  • Computed tomography (CT) is a primary diagnostic tool for acute intracranial hemorrhage.

Purpose of the Study:

  • To retrospectively analyze CT findings in patients with acute posterior fossa aneurysm rupture.
  • To compare these findings with ruptured supratentorial aneurysms and literature data.
  • To identify characteristic CT patterns suggestive of posterior fossa aneurysms.

Main Methods:

  • Retrospective review of CT scans from 20 patients with acute posterior fossa aneurysm rupture.
  • Comparison with 44 literature cases of posterior fossa aneurysms.

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  • Comparison with CT findings in ruptured supratentorial aneurysms.

    • Main Results:

    • Extravasated blood was seen in 95% of patients, intraventricular hemorrhage (IVH) in 85%, and subarachnoid hemorrhage (SAH) in 65%.
    • The frequency of extravasated blood was similar to supratentorial aneurysms.
    • A pattern of SAH with prominent fourth ventricular IVH and no intraparenchymal hematoma (55%) strongly suggested posterior fossa aneurysms.
    • IVH without SAH (25%) specifically indicated ruptured posterior inferior cerebellar artery aneurysms.

    Conclusions:

    • CT is highly sensitive for detecting extravasated blood in acute posterior fossa aneurysm rupture.
    • The presence and location of IVH, particularly in the fourth ventricle, are critical indicators.
    • Specific CT patterns can help differentiate ruptured posterior fossa aneurysms from other causes of intracranial hemorrhage.