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Author Spotlight: Imaging Pericytes Post-Subarachnoid Hemorrhaging in Rodents
Published on: August 18, 2023
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Follow-up neuroimaging after non-perimesencephalic, angiogram-negative subarachnoid hemorrhage
Jean-Philippe Dufour1, Menno R Germans1, Emanuela Keller1
1Department of Neurosurgery, Clinical Neuroscience Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Journal of Neurosurgical Sciences
|January 31, 2023
Summary
Follow-up imaging for non-perimesencephalic subarachnoid hemorrhage (NP-SAH) is crucial. Re-imaging within 8 weeks, including short-term and medium-term intervals, is recommended to detect aneurysms, while long-term imaging may offer limited diagnostic value.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Approximately 15% of spontaneous subarachnoid hemorrhage (SAH) patients lack an initial bleeding source on imaging.
- These cases are classified as perimesencephalic (PM-SAH) or non-perimesencephalic (NP-SAH).
- Optimal follow-up imaging protocols for NP-SAH remain undetermined.
Purpose of the Study:
- To determine the optimal time interval for re-imaging in NP-SAH patients.
- To evaluate the performance of magnetic resonance imaging and angiography (MRI/A) for detecting aneurysms in NP-SAH.
Main Methods:
- Retrospective analysis of 81 NP-SAH patients treated between 2005 and 2018.
- Data categorized by imaging modality and time to re-imaging: short-term (<2 weeks), medium-term (2-8 weeks), and long-term (>8 weeks).
Main Results:
- Aneurysms were diagnosed in 8 patients (9.9% yield) via digital subtraction angiography.
- Short-term re-imaging detected 5 aneurysms (6.2% yield); medium-term re-imaging detected 3 aneurysms (11.1% yield).
- No aneurysms were found beyond 8 weeks; MRI/A successfully identified aneurysms in 5 cases.
Conclusions:
- Re-imaging is essential for NP-SAH patients at both short-term and medium-term follow-up.
- Long-term re-imaging after 8 weeks appears to have limited diagnostic benefit.
- Magnetic resonance imaging and angiography (MRI/A) is a viable noninvasive re-imaging option.
