Ruptured aneurysms of anterior cerebral or anterior communicating arteries: CT patterns

Area of Science:

• Neuroradiology
• Neuroimaging
• Cerebrovascular Diseases

Background:

• Anterior communicating artery aneurysms are a common cause of subarachnoid hemorrhage.
• Early diagnosis and understanding of hemorrhage patterns are crucial for patient management.

Purpose of the Study:

• To describe the characteristic computed tomography (CT) findings in patients with ruptured anterior cerebral artery or anterior communicating artery aneurysms.
• To correlate CT findings with the location and extent of intracranial hemorrhage.

Main Methods:

• Retrospective review of CT scans from 40 patients diagnosed with ruptured anterior cerebral artery or anterior communicating artery aneurysms.
• Analysis of hemorrhage patterns, including location and distribution within the brain.
• Evaluation of postcontrast CT studies in a subset of patients to identify the aneurysmal sac.

Main Results:

• Common CT findings within 3 days of ictus included blood in the pericallosal cistern and interhemispheric fissure, caval-septal region, frontal lobes (unilateral or bilateral), and diffuse intraventricular and basal cisternal blood.
• An abnormal enhancing region, suggestive of the aneurysmal sac, was identified in 6 out of 23 patients who underwent postcontrast studies.

Conclusions:

• CT imaging demonstrates predictable patterns of hemorrhage following rupture of anterior cerebral artery or anterior communicating artery aneurysms.
• Specific CT findings can help confirm the diagnosis and assess the severity of the rupture, with contrast-enhanced CT potentially delineating the aneurysm itself.