Angio-CT. A Proposal for Emergency Diagnosis in Subarachnoid Hemorrhage as a Preliminary to Therapeutic Choices

After nine months' experience with helical CT (Elscint Twin), we describe an epicrisis in 13 patients with intracranial aneurysms, 12 of whom were referred to us by the emergency room for suspect subarachnoid hemorrhage. After standard CT scan confirming subarachnoid hemorrhage, patients underwent angio-CT with display of the sac responsible for bleeding in all cases. All patients subsequently underwent digital angiography which confirmed the angio-CT findings and in three cases disclosed associated malformations. The sensitivity, specificity and diagnostic accuracy of the technique are assessed in relation to the quality of the images obtained (MIP) in such a short time (15 min on average). The diagnostic information is comparable to that offered by angio-MR with the obvious positive and negative aspects linked to each method. Digital angiography remains the technique of choice in terms of diagnostic accuracy, but carries some risk to the patient.