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CT assessment of subarachnoid haemorrhage. A comparison between different CT methods of grading subarachnoid

A Forssell C Larsson J Ro Nnberg H Fodstad1,2,3,4,5

  • 1a Departments of Diagnostic Radiology.

British Journal of Neurosurgery
|February 8, 2017
PubMed

Insights

The extent of subarachnoid haemorrhage (SAH) on CT scans, not just localized clots, best predicts delayed ischaemic deficits in patients with aneurysmal SAH. This finding highlights the importance of overall SAH burden for patient outcomes.

Area of Science:

  • Neurosurgery
  • Radiology
  • Neurology

Background:

  • Subarachnoid haemorrhage (SAH) is a critical condition often caused by ruptured aneurysms.
  • Predicting delayed ischaemic deficits (DID) following aneurysmal SAH is crucial for patient management.
  • Computed Tomography (CT) is a primary diagnostic tool for SAH.

Purpose of the Study:

  • To evaluate various CT classifications for subarachnoid haemorrhage (SAH).
  • To determine the best CT scoring system for predicting delayed ischaemic deficits (DID) in aneurysmal SAH.
  • To understand the relationship between SAH extent and DID development.

Main Methods:

  • Applied multiple CT classifications to 50 consecutive patients with aneurysmal SAH.
  • Correlated CT findings with the occurrence of delayed ischaemic deficits (DID).
  • Developed and tested a novel scoring system based on cisternal SAH grading.

Main Results:

  • A specific CT score, summing individual cisternal grades (excluding the cortical subarachnoid space), showed the strongest correlation with DID.
  • The overall extent of SAH on CT was a more significant predictor of DID than localized clots.
  • This scoring method offers improved prediction of neurological complications.

Conclusions:

  • The extent of subarachnoid haemorrhage (SAH) on CT is a key predictor of delayed ischaemic deficits (DID).
  • A scoring system based on cisternal SAH burden, excluding cortical SAH, is valuable for predicting DID.
  • Radiological assessment of SAH extent is vital for prognostication in aneurysmal SAH.

Keywords:
Ct;Delayed Ischaemia;Subarachnoid Haemorrhage;Vasospasm

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