Journal article
Diagnostic yield of computed tomography angiography and magnetic resonance angiography in patients with catheter angiography–negative subarachnoid hemorrhage: Clinical article
Journal of neurosurgery, Vol.117(2), pp.309-315
08/2012
DOI: 10.3171/2012.4.JNS112306
PMID: 22680242
Abstract
Object The yield of CT angiography (CTA) and MR angiography (MRA) in patients with subarachnoid hemorrhage (SAH) who have a negative initial catheter angiogram is currently not well understood. This study aims to determine the yield of CTA and MRA in a prospective cohort of patients with SAH and a negative initial catheter angiogram. Methods From January 1, 2005, until September 1, 2010, the authors instituted a prospective protocol in which patients with SAH—as documented by noncontrast CT or CSF xanthochromia and a negative initial catheter angiogram— were evaluated using CTA and MRA to assess for causative cerebral aneurysms. Two neuroradiologists independently evaluated the noncontrast CT scans to determine the SAH pattern (perimesencephalic or not) and the CT and MR angiograms to assess for causative cerebral aneurysms. Results Seventy-seven patients were included, with a mean age of 52.8 years (median 54 years, range 19–88 years). Fifty patients were female (64.9%) and 27 male (35.1%). Forty-three patients had nonperimesencephalic SAH (55.8%), 29 patients had perimesencephalic SAH (37.7%), and 5 patients had CSF xanthochromia (6.5%). Computed tomography angiography demonstrated a causative cerebral aneurysm in 4 patients (5.2% yield), all of whom had nonperimesencephalic SAH (9.3% yield). Mean aneurysm size was 2.6 mm (range 2.1–3.3 mm). Magnetic resonance angiography demonstrated only 1 of these aneurysms. No causative cerebral aneurysms were found in patients with perimesencephalic SAH or CSF xanthochromia. Conclusions Computed tomography angiography is a valuable adjunct in the evaluation of patients with nonperimesencephalic SAH who have a negative initial catheter angiogram, demonstrating a causative cerebral aneurysm in 9.3% of patients.
Details
- Title: Subtitle
- Diagnostic yield of computed tomography angiography and magnetic resonance angiography in patients with catheter angiography–negative subarachnoid hemorrhage: Clinical article
- Creators
- Josser E Delgado Almandoz - 1Division of Neuroradiology, Mallinckrodt Institute of Radiology,, 5Division of Interventional Neuroradiology, Abbott Northwestern Hospital, andBharathi D Jagadeesan - 1Division of Neuroradiology, Mallinckrodt Institute of Radiology,, 6Division of Interventional Neuroradiology, University of Minnesota School of Medicine, Minneapolis, Minnesota; andDaniel Refai - 7Department of Neurological Surgery, Emory University, Atlanta, GeorgiaChristopher J Moran - 1Division of Neuroradiology, Mallinckrodt Institute of Radiology,, 2Department of Neurological SurgeryDeWitte T Cross - 1Division of Neuroradiology, Mallinckrodt Institute of Radiology,, 2Department of Neurological SurgeryMichael R Chicoine - 2Department of Neurological SurgeryKeith M Rich - 2Department of Neurological SurgeryMichael N Diringer - 3Department of Neurology, and, 4Neurology/Neurosurgery Intensive Care Unit, Washington University School of Medicine, Saint Louis, MissouriRalph G Dacey - 2Department of Neurological SurgeryColin P Derdeyn - 1Division of Neuroradiology, Mallinckrodt Institute of Radiology,, 2Department of Neurological Surgery,, 3Department of Neurology, andGregory J Zipfel - 2Department of Neurological Surgery,, 3Department of Neurology, and
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.117(2), pp.309-315
- DOI
- 10.3171/2012.4.JNS112306
- PMID
- 22680242
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 08/2012
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020756702771
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