Angiogram-negative subarachnoid hemorrhage in the era of three dimensional rotational angiography

Ishihara, Hideyuki; Kato, Shoichi; Akimura, Tatsuo; Suehiro, Eiichi; Oku, Takayuki; Suzuki, Michiyasu

doi:10.1016/j.jocn.2006.01.011

Cited by 43 publications

(32 citation statements)

References 17 publications

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“…Similar to most of the studies, in our study the most common diagnosis with negative angiography was missed aneurysms [16,17]. The Acom aneurysms had most false negativity in angiography in agreement with other studies [18,19]. Causes suggested for inducing false negative angiography may include technical errors such as incomplete angiographic views, presence of vasospasm (especially on the 3rd to 14th day of hemorrhage), presence of hematoma mass-effect, existence of thrombosis in the neck of aneurysms and injection of hyperosmolar contrast [20][21][22][23][24][25][26][27].…”

Section: Discussionsupporting

confidence: 92%

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Gharib-Salehi

Alimohammadi

Bagheri

et al. 2017

IrJNS

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Background and Aim:This study aimed at analyzing the demographic characteristics of the patients with non-traumatic intracranial hemorrhage, their angiographic results and the correlation between computed tomography (CT) scan and angiography findings. Methods and Materials/Patients:In a descriptive study, we retrospectively reviewed the records of the patients with non-traumatic intracranial hemorrhage based on their brain CT or lumbar puncture findings from 2011 to 2017. For all patients, four vessel catheter angiography via the femoral approach was performed in the Medical Imaging Center of Kermanshah University of Medical Sciences, Iran. Results:We investigated 143 cases with non-traumatic intracranial hemorrhage which was indicated in CT findings (91.61%) or lumbar puncture (8.39%). Of 143 patients, 64 (44.8%) were men and 79 (55.2%) women (mean age 53.7±12.1 years old). Moreover, 104(72.7%) patients had Subarachnoid Hemorrhage (SAH), 19(13.3%) of them had Intracranial Hemorrhage (ICH), 8(5.6%) ones had Intraventricular Hemorrhage (IVH) and 12(8.4%) patients had normal brain CT. There were 100 cases of aneurysm (69.93%), 13 cases of Arteriovenous Malformations (AVM) (9.09%), 28 cases with negative angiograms (19.58%), and 2 cases with other pathologies (1.4%). Seven (4.89%) cases of multiple aneurysms were also recorded. Of 13 patients with AVM, 8(61.5%) patients had AVM in parieto-occipital region, 2(15.4%) in temporal, 1(7.7%) in frontal region and 2(15.4%) had deep AVM. Two (1.4%) patients with SAH had dural AVF. Twenty-eight (19.6%) patients had negative angiogram, 22 cases of them had second angiography after one to two weeks. The most common positive finding in the second angiogram was Acom aneurysm (18.18%). Conclusion:Aneurysms and AVMs are the most common causes of non-traumatic intracranial hemorrhage. The most common site of intracranial aneurysms is the circle of Willis. A second angiogram after one to two weeks is necessary in most patients with negative results in first angiography after non-traumatic intracranial hemorrhage.

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Section: Discussionsupporting

confidence: 92%

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Gharib-Salehi

Alimohammadi

Bagheri

et al. 2017

IrJNS

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“…Threedimensional cerebral angiography is more sensitive for detecting aneurysms than 2-dimensional angiography. 121, 122 The combination of 3-and 2-dimensional cerebral angiography usually provides the best morphological depiction of aneurysm anatomy with high spatial resolution, and it is, of course, always used in preparation for endovascular therapy.…”

Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Connolly¹,

Rabinstein²,

Carhuapoma³

et al. 2012

Stroke

2,883

1,375

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Purpose— The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH). Methods— A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. The guideline draft was reviewed by 7 expert peer reviewers and by the members of the Stroke Council Leadership and Manuscript Oversight Committees. It is intended that this guideline be fully updated every 3 years. Results— Evidence-based guidelines are presented for the care of patients presenting with aSAH. The focus of the guideline was subdivided into incidence, risk factors, prevention, natural history and outcome, diagnosis, prevention of rebleeding, surgical and endovascular repair of ruptured aneurysms, systems of care, anesthetic management during repair, management of vasospasm and delayed cerebral ischemia, management of hydrocephalus, management of seizures, and management of medical complications. Conclusions— aSAH is a serious medical condition in which outcome can be dramatically impacted by early, aggressive, expert care. The guidelines offer a framework for goal-directed treatment of the patient with aSAH.

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“…6,7,[10][11][12][13][14][16][17][18][19][21][22][23][24][25][26][27][28]30,31 To date, only 1 study has examined the yield of DSA in patients with a negative initial CTA, which was 10% in patients with diffuse SAH, 17% in patients with peripheral sulcal SAH, and 0% in patients with perimesencephalic SAH. 29 The present study aimed to determine the yield of DSA for the detection of causative vascular lesions in a cohort of patients with SAH who had negative initial noninvasive neurovascular examinations (CTA or MRA).…”

Section: 35mentioning

confidence: 99%

Diagnostic Yield of Catheter Angiography in Patients with Subarachnoid Hemorrhage and Negative Initial Noninvasive Neurovascular Examinations

Almandoz

Crandall

Fease

et al. 2012

AJNR Am J Neuroradiol

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Angiogram-negative subarachnoid hemorrhage in the era of three dimensional rotational angiography

Cited by 43 publications

References 17 publications

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Diagnostic Yield of Catheter Angiography in Patients with Subarachnoid Hemorrhage and Negative Initial Noninvasive Neurovascular Examinations

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