Magnetic resonance imaging with aneurysmal subarachnoid hemorrhage: comparison with computed tomography scan

Magnetic resonance studies of 27 consecutive preoperative and 33 postoperative patients with cerebral aneurysm and subarachnoid hemorrhage were reviewed. Magnetic resonance imaging using a 0.5- or 0.22-Tesla unit was at least as accurate as computed tomography scan for detection of acute subarachnoid hemorrhage. Magnetic resonance imaging was superior to computed tomography scan for demonstrating blood in the ventricles or posterior fossa subarachnoid space, transependymal migration of the cerebrospinal fluid, and several kinds of iatrogenic intracranial pathologies in postoperative patients. Ischemic lesions, particularly fresh lesions caused by delayed cerebral vasospasm, were much better shown on magnetic resonance imaging than on computed tomography scan. Nonferromagnetic Sugita clips caused significant artifacts, but the area of artifacts was consistently smaller, and a reasonable evaluation of structures relatively closer to the clip was possible with magnetic resonance imaging rather than computed tomography scan.