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Computertomography in subarachnoid haemorrhage and aneurysm
Insights
Subarachnoid hemorrhage (SAH) patients often show blood on CT scans for up to 9 days. Aneurysms, intracerebral hemorrhage, and infarcts are common findings, with vasospasm linked to recent infarcts.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Subarachnoid hemorrhage (SAH) is a critical condition often caused by ruptured cerebral aneurysms.
- Early detection and characterization of SAH complications are vital for patient management.
- Computed tomography (CT) and angiography are key diagnostic tools in SAH evaluation.
Purpose of the Study:
- To investigate the diagnostic yield of CT and angiography in patients with SAH.
- To determine the frequency of aneurysms, intracerebral hemorrhage, infarcts, and hydrocephalus in SAH patients.
- To explore the relationship between vasospasm and recent infarcts in the context of SAH.
Main Methods:
- Retrospective analysis of 50 patients diagnosed with SAH and suspected aneurysms.
- Utilized CT scans and angiography for patient investigation.
- Assessed the presence and timing of blood in cerebrospinal fluid (CSF) spaces on CT scans.
Main Results:
- 67 aneurysms were identified in 59 patients.
- Blood in CSF spaces was visualized on CT up to 9 days post-SAH in 67% of patients.
- Findings included aneurysms (31%), intracerebral hemorrhage (29%), recent infarcts (19%), and hydrocephalus (13%).
- Vasospasm was observed in 8 of 12 patients with recent infarcts, correlating temporally and spatially.
Conclusions:
- CT is effective in visualizing SAH and associated findings for up to 9 days.
- Aneurysms and intracerebral hemorrhages are frequent complications of SAH.
- Vasospasm is a significant factor in the development of recent infarcts following SAH.
Abstract:
50 patients with SAH and an aneurysm were investigated by CT and angiography. In the 59 patients 67 aneurysms were found. The mean interval between SAH and CT was 8 days, between SAH and angiography II days. Blood in the CSF space was visualized up to the 9th day in the patients and 67% of those investigated showed blood in the CSF-space in the CT. In 31% of the patients an aneurysm, in 29% an intracerebral haemorrhage and in 19% a recent infarct was found. A hydrocephalus was seen in 13% of the patients. Of 12 patients with recent infarcts 8 showed vasospasm which correlated in time and location with the infarct.