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[Angiogram-negative subarachnoid hemorrhage. Should the procedure be repeated?]
J A Salazar Benítez1, M Bravo Utrera, M Hervás García
1Servicio de Neurología, Hospital Regional de Málaga.
Neurologia (Barcelona, Spain)
|August 1, 1996
Summary
Repeat cerebral angiography if the initial study is negative for non-traumatic subarachnoid hemorrhage. A second angiogram can detect previously unseen aneurysms, improving diagnosis for this serious condition.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Context:
- Non-traumatic subarachnoid hemorrhage (SAH) often results from ruptured aneurysms or arteriovenous malformations.
- Initial cerebral angiography is normal in approximately 20% of SAH cases.
- Diagnostic uncertainty necessitates evaluating repeat angiography protocols.
Purpose:
- To review the necessity of repeat angiography when the initial cerebral angiogram is negative in non-traumatic SAH cases.
- To analyze the diagnostic yield of repeat angiography in patients with initially negative studies.
Summary:
- A review of 112 non-traumatic SAH cases found 27 (24.1%) had initially negative cerebral angiograms.
- Repeat angiography identified previously undetected aneurysms in 2 patients (7.4%).
- The low complication rate of angiography supports its repeated use in cases of suspected SAH with negative initial findings.
Impact:
- Repeat angiography is recommended for non-traumatic SAH when the initial study is negative, barring contraindications.
- This approach can improve the detection rate of causative vascular lesions.
- Optimizing diagnostic strategies for SAH is crucial for timely and effective patient management.