S B T van Rooij1, R S Bechan2, W J van Rooij3, M E Sprengers4. 1. From the Department of Radiology (S.B.T.v.R.), Noordwest ZIekenhuisgroep Alkmaar, the Netherlands s.b.t.rooij@gmail.com. 2. Universitair Medisch Centrum Amsterdam (R.S.B.), Vrije Universiteit, Amsterdam, the Netherlands. 3. Algemeen Ziekenhuis Turnhout (W.J.v.R.), Turnhout, Belgium. 4. Universitair Medisch Centrum Amsterdam (M.E.S.), Academisch Medisch Centrum, Amsterdam, the Netherlands.
Abstract
BACKGROUND AND PURPOSE: Aneurysmal subarachnoid hemorrhage is an important cause of mortality and morbidity. Modern hospital demographics are scarce. We evaluated the diagnosis and treatment of patients with SAH in a neurosurgical referral center. MATERIALS AND METHODS: Between March 2013 and April 2015, two hundred eighty-four patients with SAH diagnosed on CT or lumbar puncture were admitted. All patients underwent 64- to 128-detector row CT angiography. Additional imaging was with 3D rotational angiography of all vessels. In patients with aneurysms, characteristics and mode of treatment were recorded. RESULTS: In 197 of 220 patients with an aneurysmal bleeding pattern, we found a cause of the bleeding: One hundred ninety-five patients had a ruptured aneurysm (98%); 1 patient, a micro-AVM; and 1 patient, reversible vasoconstriction syndrome. Of 195 ruptured aneurysms, 6 were dissecting aneurysms and 3 were AVM-associated flow aneurysms. In 23 of 204 patients (11%) with an aneurysmal bleeding pattern and 3D rotational angiography performed, no cause was found. In 8 of 9 patients (89%) with lumbar puncture positive for SAH but CT negative for it, no cause was found. Of 180 patients with a ruptured aneurysm eligible for treatment, 147 (82%) were treated endovascularly and 30 aneurysms (17%) were clipped. Of 204 patients with an aneurysmal bleeding pattern and 3D rotational angiography, 72 (35%) had multiple aneurysms. These 72 patients had, altogether, 117 additional aneurysms, of which 24 (21%) were treated by either coiling or clipping. CONCLUSIONS: This study provides robust data on hospital demographics of SAH in a neurosurgical referral center, based on CTA and 3D rotational angiography of all vessels.
BACKGROUND AND PURPOSE:Aneurysmal subarachnoid hemorrhage is an important cause of mortality and morbidity. Modern hospital demographics are scarce. We evaluated the diagnosis and treatment of patients with SAH in a neurosurgical referral center. MATERIALS AND METHODS: Between March 2013 and April 2015, two hundred eighty-four patients with SAH diagnosed on CT or lumbar puncture were admitted. All patients underwent 64- to 128-detector row CT angiography. Additional imaging was with 3D rotational angiography of all vessels. In patients with aneurysms, characteristics and mode of treatment were recorded. RESULTS: In 197 of 220 patients with an aneurysmal bleeding pattern, we found a cause of the bleeding: One hundred ninety-five patients had a ruptured aneurysm (98%); 1 patient, a micro-AVM; and 1 patient, reversible vasoconstriction syndrome. Of 195 ruptured aneurysms, 6 were dissecting aneurysms and 3 were AVM-associated flow aneurysms. In 23 of 204 patients (11%) with an aneurysmal bleeding pattern and 3D rotational angiography performed, no cause was found. In 8 of 9 patients (89%) with lumbar puncture positive for SAH but CT negative for it, no cause was found. Of 180 patients with a ruptured aneurysm eligible for treatment, 147 (82%) were treated endovascularly and 30 aneurysms (17%) were clipped. Of 204 patients with an aneurysmal bleeding pattern and 3D rotational angiography, 72 (35%) had multiple aneurysms. These 72 patients had, altogether, 117 additional aneurysms, of which 24 (21%) were treated by either coiling or clipping. CONCLUSIONS: This study provides robust data on hospital demographics of SAH in a neurosurgical referral center, based on CTA and 3D rotational angiography of all vessels.
Authors: Ana Marcos Gonzalez; Ana Paula Narata; Hasan Yilmaz; Philippe Bijlenga; Ivan Radovanovic; Karl Schaller; Karl-Olof Lovblad; Vitor Mendes Pereira Journal: Eur J Radiol Date: 2013-10-06 Impact factor: 3.528
Authors: Liselore A Mensing; Mervyn D I Vergouwen; Kamil G Laban; Ynte M Ruigrok; Birgitta K Velthuis; Ale Algra; Gabriel J E Rinkel Journal: Stroke Date: 2018-04-25 Impact factor: 7.914