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Related Experiment Videos

[Subarachnoidal hemorrhage with cranial tomography without bleeding signals]

S Francisco1, J B dos Reis-Filho, A C Neves

  • 1Disciplina de Neurologia da UNIFESP, Escola Paulista de Medicina, Brasil.

Arquivos De Neuro-Psiquiatria
|June 18, 1998
PubMed
Summary

Cerebrospinal fluid (CSF) testing is crucial for diagnosing subarachnoid hemorrhage (SAH) when initial cranial tomography (CT) scans show no bleeding. This diagnostic approach ensures accurate SAH identification, even with delayed imaging.

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Sharron Francisco, RN, BSN.

Nursing forum·1999

Area of Science:

  • Neurology
  • Radiology
  • Clinical Diagnostics

Context:

  • Subarachnoid hemorrhage (SAH) diagnosis can be challenging, particularly when initial imaging is inconclusive.
  • Cranial tomography (CT) scans may fail to detect bleeding in SAH cases, especially within specific timeframes post-ictus.
  • Cerebrospinal fluid (CSF) analysis remains a gold standard for confirming SAH.

Purpose:

  • To evaluate the diagnostic utility of CSF analysis in patients with suspected SAH and negative CT findings.
  • To determine the optimal timing for CT and CSF collection in SAH diagnosis.
  • To correlate angiographic findings with clinical presentation in SAH patients.

Summary:

  • This study analyzed 23 patients with suspected SAH and negative CT scans, where diagnosis was confirmed by CSF analysis.

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  • The most sensitive time for CT detection of SAH was between 24-48 hours post-ictus.
  • Brain angiography revealed aneurysms in 55% of cases, primarily in the carotid and anterior cerebral artery territories, with most patients presenting as Hunt & Hess grade I or II.

    • Impact:

    • Highlights the critical role of CSF testing in diagnosing SAH when CT is negative.
    • Provides insights into the temporal window for sensitive CT detection of SAH.
    • Contributes to understanding the prevalence and location of aneurysms in SAH patients and their clinical severity.