Journal article
Diagnostic Yield of Repeat Catheter Angiography in Patients With Catheter and Computed Tomography Angiography Negative Subarachnoid Hemorrhage
Neurosurgery, Vol.70(5), pp.1135-1142
05/01/2012
DOI: 10.1227/NEU.0b013e318242575e
PMID: 22105208
Abstract
Abstract
BACKGROUND:
The yield of repeat catheter angiography in patients with subarachnoid hemorrhage (SAH) who have negative initial catheter and computed tomography (CT) angiograms is not well understood.
OBJECTIVE:
To determine the yield of repeat catheter angiography in a prospective cohort of patients with SAH and negative initial catheter and CT angiograms.
METHODS:
From January 1, 2005, until September 1, 2010, we instituted a prospective protocol in which patients with SAH documented by noncontrast CT (NCCT) or cerebrospinal fluid (CSF) xanthochromia and negative initial catheter and CT angiograms were evaluated with repeat catheter angiography 7 days and 3 months after presentation to assess for causative vascular abnormalities.
RESULTS:
Seventy-two patients were included, with a mean age of 53.1 years (median, 53.5 years; range, 19-88 years). Forty-six patients were female (63.9%) and 26 male (36.1%). Thirty-nine patients had nonperimesencephalic SAH (54.2%), 29 patients had perimesencephalic SAH (40.3%), and 4 patients had CSF xanthochromia (5.5%). The first repeat catheter angiogram performed 7 days after presentation demonstrated a causative vascular abnormality in 3 patients (yield of 4.2%), 2 of which had nonperimesencephalic SAH (yield of 5.1%), and 1 had perimesencephalic SAH (yield of 3.4%). The second repeat catheter angiogram performed in 43 patients (59.7%) did not demonstrate any causative vascular abnormalities. No causative abnormalities were found in patients with CSF xanthochromia.
CONCLUSION:
Repeat catheter angiography performed 7 days after presentation is valuable in the evaluation of patients with SAH who have negative initial catheter and CT angiograms, demonstrating a causative vascular abnormality in 4.2% of patients.
Details
- Title: Subtitle
- Diagnostic Yield of Repeat Catheter Angiography in Patients With Catheter and Computed Tomography Angiography Negative Subarachnoid Hemorrhage
- Creators
- Josser E Delgado Almandoz - Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MissouriBharathi D Jagadeesan - Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MissouriDaniel Refai - ‖Department of Neurological Surgery, Emory University, Atlanta, GeorgiaChristopher J Moran - Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MissouriDeWitte T Cross - Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MissouriMichael R Chicoine - ¶Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MissouriKeith M Rich - ¶Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MissouriMichael N Diringer - #Department of Neurology, Washington University School of Medicine, Saint Louis, MissouriRalph G Dacey - ¶Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, MissouriColin P Derdeyn - Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MissouriGregory J Zipfel - ¶Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri
- Resource Type
- Journal article
- Publication Details
- Neurosurgery, Vol.70(5), pp.1135-1142
- Publisher
- Oxford University Press
- DOI
- 10.1227/NEU.0b013e318242575e
- PMID
- 22105208
- ISSN
- 0148-396X
- eISSN
- 1524-4040
- Language
- English
- Date published
- 05/01/2012
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020650702771
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