MRI-detection rate and incidence of lumbar bleeding sources in 190 patients with non-aneurysmal SAH

Kashefiolasl, Sepide; Brawanski, Nina; Platz, Johannes; Bruder, Markus; Senft, Christian; Marquardt, Gerhard; Seifert, Volker; Tritt, Stephanie; Konczalla, Juergen

doi:10.1371/journal.pone.0174734

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…These methods are minimally invasive or noninvasive, time-saving, and lowcost and produce high-quality images. However, the clinical effects reported in some studies are quite different [2,3].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Low-Dose 256-Slice Spiral CT Angiography, MR Angiography, and 3D-DSA in Cerebral Aneurysms

Feng

Shu

2020

Disease Markers

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Objective. To evaluate the diagnostic value of low-dose 256-slice CT angiography (CTA), MR angiography (MRA), and three dimensional-digital subtraction angiography (3D-DSA) in cerebral aneurysms. Methods. CTA, MRA, and 3D-DSA were performed in all enrolled patients to explore the diagnostic significance of the three different examinations. Results. There were 92 aneurysms confirmed during DSA and surgery in 79 patients. The diagnostic coincidence rates of DSA, CTA, and MRA were 96.7%, 89.1%, and 86%, respectively. The diagnostic coincidence rates of CTA and MRA were lower than those of DSA. The detection rate of CTA for aneurysms less than 3 mm in diameter was higher than that of MRA. Conclusion. CTA, DSA, and MRA have their own advantages and disadvantages in the diagnosis of cerebral aneurysms. They all have the diagnostic value for aneurysms.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Low-Dose 256-Slice Spiral CT Angiography, MR Angiography, and 3D-DSA in Cerebral Aneurysms

Feng

Shu

2020

Disease Markers

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“…We report a spinal bleeding source in 2.86% of patients with AN-SAH. Kashefiolasl et al [27] reported an MRI detection rate and incidence of lumbar bleeding sources of 1.05% among 190 patients with AN-SAH. Some authors have reported a spinal tumor as the bleeding source [27, 28].…”

Section: Discussionmentioning

confidence: 99%

Frequency and Characteristics of Spinal Bleeding Sources in Nontraumatic Angiogram-Negative Subarachnoid Hemorrhage

Lampmann,

Brandecker,

Weller

et al. 2023

Cerebrovasc Dis Extra

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Introduction: Angiogram-negative subarachnoid hemorrhage (AN-SAH) accounts for 5–15% of spontaneous SAH. This study aims to analyze the frequency and characteristics of spinal bleeding sources in patients with AN-SAH. Methods: 140 patients suffering from AN-SAH treated at our institution from 2012 to 2022 were included in this retrospective cohort study. Results: 52.1% were diagnosed with perimesencephalic SAH, 35.0% with non-perimesencephalic SAH and 12.9% with CT-negative SAH (diagnosed by lumbar puncture). Additional MRI identified a spinal bleeding source in 4 patients (2.86%). These patients presented with local spine pain or neurological deficits (RR 3.9706 [95%-CI: 0.7272–21.6792]; p<0.001) and were younger (mean difference 14.85 years [95%-CI: 0.85–28.85; p=0.038]) compared to patients without a spinal bleeding source. Conclusions: AN-SAH caused by spinal pathology is rare. This study indicates that craniocervical and holospinal MRI should be considered in AN-SAH, especially for young patients with AN-SAH who present with back pain or neurological deficits.

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“…The detection rate increased by up to 25% in cases where patients with radicular sciatic pain at the presentation of symptoms received an MRI. The study concluded that routine radiological investigation of the spine in every NASAH patient is not recommended due to the rarity of the pathology and should be done as symptom orientated ( 7 ). Similar findings were also noted in five other studies investigating NASAH via MRI spine to locate the source of bleeding; they report only a 1% positive finding ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Intracranial SAHs caused by spine vascular abnormalities are extremely rare. In a literature search, only five studies were found published in the past decade (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Intracranial Subarachnoid Haemorrhage Caused by Cervical Spinal Dural Arteriovenous Fistulas: Case Report

et al. 2021

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Cervical spinal vascular abnormalities commonly present with progressive myelopathy as a result of venous congestion. They are not very prone to bleed and tend to be underdiagnosed due to their subtle clinical presentation. We came across a rare case of intracranial subarachnoid haemorrhage caused by cervical spinal dural fistula in the Imperial College Healthcare NHS Trust Hospitals/UK in June 2020. We diagnosed the patient under strict evidence base medicine guidance, which otherwise would have been missed. We discussed the case in several multidisciplinary team (MDT) meetings, and patient was treated under the joint care of the neurology and neurosurgical teams. Patient made a full recovery and discharged home with no neurological defects or complications. Here, we reported this case with all the evidence we gathered from our MDT discussion. We hope our experience would help improve the diagnosis and management protocol for future patients with a similar condition.

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MRI-detection rate and incidence of lumbar bleeding sources in 190 patients with non-aneurysmal SAH

Cited by 7 publications

References 27 publications

Diagnostic Value of Low-Dose 256-Slice Spiral CT Angiography, MR Angiography, and 3D-DSA in Cerebral Aneurysms

Diagnostic Value of Low-Dose 256-Slice Spiral CT Angiography, MR Angiography, and 3D-DSA in Cerebral Aneurysms

Frequency and Characteristics of Spinal Bleeding Sources in Nontraumatic Angiogram-Negative Subarachnoid Hemorrhage

Intracranial Subarachnoid Haemorrhage Caused by Cervical Spinal Dural Arteriovenous Fistulas: Case Report

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