Subarachnoid hemorrhage other imaging findings: Difference between revisions
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Once a subarachnoid hemorrhage is confirmed, the next question is about its origin. CT angiography (using [[radiocontrast]]) to identify aneurysms is generally the first step, as invasive [[angiography]] (injecting radiocontrast through a catheter advanced to the brain arteries) has a small rate of complications but is useful if there are plans to obliterate the source of bleeding, such as an aneurysm, at the same time. | Once a subarachnoid hemorrhage is confirmed, the next question is about its origin. CT angiography (using [[radiocontrast]]) to identify aneurysms is generally the first step, as invasive [[angiography]] (injecting radiocontrast through a catheter advanced to the brain arteries) has a small rate of complications but is useful if there are plans to obliterate the source of bleeding, such as an aneurysm, at the same time. | ||
===Digital-subtraction cerebral angiography=== | ===Digital-subtraction cerebral angiography=== | ||
Digital-subtraction cerebral angiography is used in following conditions: | Digital-subtraction cerebral angiography is used in following conditions:<ref name="pmid22143927">{{cite journal| author=Lu L, Zhang LJ, Poon CS, Wu SY, Zhou CS, Luo S et al.| title=Digital subtraction CT angiography for detection of intracranial aneurysms: comparison with three-dimensional digital subtraction angiography. | journal=Radiology | year= 2012 | volume= 262 | issue= 2 | pages= 605-12 | pmid=22143927 | doi=10.1148/radiol.11110486 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22143927 }} </ref><ref name="pmid19508992">{{cite journal| author=Li Q, Lv F, Li Y, Luo T, Li K, Xie P| title=Evaluation of 64-section CT angiography for detection and treatment planning of intracranial aneurysms by using DSA and surgical findings. | journal=Radiology | year= 2009 | volume= 252 | issue= 3 | pages= 808-15 | pmid=19508992 | doi=10.1148/radiol.2523081911 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19508992 }} </ref><ref name="pmid9933266">{{cite journal| author=Cloft HJ, Joseph GJ, Dion JE| title=Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. | journal=Stroke | year= 1999 | volume= 30 | issue= 2 | pages= 317-20 | pmid=9933266 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9933266 }} </ref> | ||
*In patients with uncertain diagnosis after CT scan and LP | *In patients with uncertain diagnosis after CT scan and LP | ||
*In patients with septic endocarditis and SAH to search for mycotic aneurysms | *In patients with septic endocarditis and SAH to search for mycotic aneurysms | ||
| Line 16: | Line 16: | ||
**Relation of the aneurysm to the parent artery and perforating arteries | **Relation of the aneurysm to the parent artery and perforating arteries | ||
**Presence of multiple or mirror aneurysms | **Presence of multiple or mirror aneurysms | ||
===CT and MR angiography=== | ===CT angiography=== | ||
CT angiography of the intracranial vessels is noninvasive test which is routinely performed in patients presenting with acute subarachnoid hemorrhage.<ref name="pmid19556531">{{cite journal| author=Li MH, Cheng YS, Li YD, Fang C, Chen SW, Wang W et al.| title=Large-cohort comparison between three-dimensional time-of-flight magnetic resonance and rotational digital subtraction angiographies in intracranial aneurysm detection. | journal=Stroke | year= 2009 | volume= 40 | issue= 9 | pages= 3127-9 | pmid=19556531 | doi=10.1161/STROKEAHA.109.553800 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19556531 }} </ref><ref name="pmid12590688">{{cite journal| author=Chappell ET, Moure FC, Good MC| title=Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis. | journal=Neurosurgery | year= 2003 | volume= 52 | issue= 3 | pages= 624-31; discussion 630-1 | pmid=12590688 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12590688 }} </ref> | |||
*It is useful for screening and pre surgical planning | |||
*It can identify aneurysms 3 to 5 mm or larger with a high degree of sensitivity | |||
Advantages of CTA may include:<ref name="pmid17641372">{{cite journal| author=Papke K, Kuhl CK, Fruth M, Haupt C, Schlunz-Hendann M, Sauner D et al.| title=Intracranial aneurysms: role of multidetector CT angiography in diagnosis and endovascular therapy planning. | journal=Radiology | year= 2007 | volume= 244 | issue= 2 | pages= 532-40 | pmid=17641372 | doi=10.1148/radiol.2442060394 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17641372 }} </ref> | |||
*The speed and ease by which it can be obtained | |||
*Usefulness in the acute setting in a rapidly declining patient who needs emergent craniotomy for hematoma evacuation | |||
*Offers a more practical approach to acute diagnosis | |||
===MR angiography=== | |||
MR angiography of the intracranial vessels is noninvasive test which is routinely performed in patients presenting with acute subarachnoid hemorrhage.<ref name="pmid19556531">{{cite journal| author=Li MH, Cheng YS, Li YD, Fang C, Chen SW, Wang W et al.| title=Large-cohort comparison between three-dimensional time-of-flight magnetic resonance and rotational digital subtraction angiographies in intracranial aneurysm detection. | journal=Stroke | year= 2009 | volume= 40 | issue= 9 | pages= 3127-9 | pmid=19556531 | doi=10.1161/STROKEAHA.109.553800 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19556531 }} </ref> | |||
*It is useful for screening and pre surgical planning | |||
*It can identify aneurysms 3 to 5 mm or larger with a high degree of sensitivity | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 02:29, 13 December 2016
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Subarachnoid Hemorrhage Microchapters |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)
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Subarachnoid hemorrhage other imaging findings On the Web |
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American Roentgen Ray Society Images of Subarachnoid hemorrhage other imaging findings |
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Risk calculators and risk factors for Subarachnoid hemorrhage other imaging findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Other imaging findings
Once a subarachnoid hemorrhage is confirmed, the next question is about its origin. CT angiography (using radiocontrast) to identify aneurysms is generally the first step, as invasive angiography (injecting radiocontrast through a catheter advanced to the brain arteries) has a small rate of complications but is useful if there are plans to obliterate the source of bleeding, such as an aneurysm, at the same time.
Digital-subtraction cerebral angiography
Digital-subtraction cerebral angiography is used in following conditions:[1][2][3]
- In patients with uncertain diagnosis after CT scan and LP
- In patients with septic endocarditis and SAH to search for mycotic aneurysms
- To provide surgical information such as:
- Cerebrovascular anatomy
- Aneurysm location and source of bleeding
- Aneurysm size and shape
- Relation of the aneurysm to the parent artery and perforating arteries
- Presence of multiple or mirror aneurysms
CT angiography
CT angiography of the intracranial vessels is noninvasive test which is routinely performed in patients presenting with acute subarachnoid hemorrhage.[4][5]
- It is useful for screening and pre surgical planning
- It can identify aneurysms 3 to 5 mm or larger with a high degree of sensitivity
Advantages of CTA may include:[6]
- The speed and ease by which it can be obtained
- Usefulness in the acute setting in a rapidly declining patient who needs emergent craniotomy for hematoma evacuation
- Offers a more practical approach to acute diagnosis
MR angiography
MR angiography of the intracranial vessels is noninvasive test which is routinely performed in patients presenting with acute subarachnoid hemorrhage.[4]
- It is useful for screening and pre surgical planning
- It can identify aneurysms 3 to 5 mm or larger with a high degree of sensitivity
References
- ↑ Lu L, Zhang LJ, Poon CS, Wu SY, Zhou CS, Luo S; et al. (2012). "Digital subtraction CT angiography for detection of intracranial aneurysms: comparison with three-dimensional digital subtraction angiography". Radiology. 262 (2): 605–12. doi:10.1148/radiol.11110486. PMID 22143927.
- ↑ Li Q, Lv F, Li Y, Luo T, Li K, Xie P (2009). "Evaluation of 64-section CT angiography for detection and treatment planning of intracranial aneurysms by using DSA and surgical findings". Radiology. 252 (3): 808–15. doi:10.1148/radiol.2523081911. PMID 19508992.
- ↑ Cloft HJ, Joseph GJ, Dion JE (1999). "Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis". Stroke. 30 (2): 317–20. PMID 9933266.
- ↑ 4.0 4.1 Li MH, Cheng YS, Li YD, Fang C, Chen SW, Wang W; et al. (2009). "Large-cohort comparison between three-dimensional time-of-flight magnetic resonance and rotational digital subtraction angiographies in intracranial aneurysm detection". Stroke. 40 (9): 3127–9. doi:10.1161/STROKEAHA.109.553800. PMID 19556531.
- ↑ Chappell ET, Moure FC, Good MC (2003). "Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis". Neurosurgery. 52 (3): 624–31, discussion 630-1. PMID 12590688.
- ↑ Papke K, Kuhl CK, Fruth M, Haupt C, Schlunz-Hendann M, Sauner D; et al. (2007). "Intracranial aneurysms: role of multidetector CT angiography in diagnosis and endovascular therapy planning". Radiology. 244 (2): 532–40. doi:10.1148/radiol.2442060394. PMID 17641372.