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Cisternal enhancement after subarachnoid hemorrhage.

D Sobel, F C Li, D Norman

AJNR. American Journal of Neuroradiology

|November 1, 1981

Summary

Abnormal enhancement in brain cisterns after subarachnoid hemorrhage was seen in half of patients. This finding, similar to infections or tumors, correlated with hydrocephalus but not clinical severity.

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Area of Science:

Neuroradiology
Neurocritical Care
Neuropathology

Background:

Subarachnoid hemorrhage (SAH) can lead to complex post-event changes.
Computed tomography (CT) is crucial for diagnosing SAH and monitoring complications.
Cisternal enhancement on CT post-SAH is an under-recognized phenomenon.

Purpose of the Study:

To describe the incidence and characteristics of abnormal computed tomographic enhancement in basal cisterns and cortical sulci following subarachnoid hemorrhage.
To investigate the association of this enhancement pattern with clinical factors and outcomes, including hydrocephalus.

Main Methods:

Retrospective review of computed tomographic scans from 42 patients diagnosed with subarachnoid hemorrhage.
Analysis of enhancement patterns in basal cisterns and cortical sulci.
Correlation of enhancement findings with clinical grade, arterial spasm, bleed location, temporal relation to bleed, and development of hydrocephalus.

Main Results:

Abnormal CT enhancement in basal cisterns and cortical sulci was observed in 21 of 42 patients (50%).
This enhancement pattern was significantly associated with an increased incidence of hydrocephalus.
No correlation was found between cisternal enhancement and clinical grade, arterial spasm, location of bleed, or timing relative to the hemorrhage.

Conclusions:

Abnormal cisternal and sulcal enhancement on CT is a notable finding after subarachnoid hemorrhage.
The enhancement is likely related to increased vascular permeability and subsequent arachnoiditis.
This CT finding may serve as an imaging marker for increased risk of hydrocephalus post-SAH.

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