BACKGROUND: Angiography is usually recommended in perimesencephalic subarachnoid haemorrhage (PM SAH) to rule out a basilar artery aneurysm. However it is not known how often aneurysms are found among patients with a CT pattern of PM haemorrhage or the frequency of this CT pattern after rupture of posterior circulation aneurysms. METHOD: CTs of all SAH caused by posterior circulation aneurysms admitted from 1/85 to 12/92 where reviewed by two examiners. Late (> 72h) examinations were excluded. The remaining CTs were classified in perimesencephalic (PM) or non PM. RESULTS: 81 posterior circulation aneurysms were collected. Only one PM-like CT pattern was found, due to ruptured posterior communicating artery aneurysm (1.3%; 95% Cl (confidence intervals) = .03-6.7%). During the same period 37 PM SAH with negative angiographic results were admitted. The likelihood of finding an aneurysm in a patient with an early CT showing a PM distribution of haematic densities was 2.7% (95% Cl = .07-.14%). CONCLUSIONS: Although the probability of finding an aneurysm in a SAH patient with a PM CT pattern is low, a complete 4-vessel angiogram must be obtained.
BACKGROUND: Angiography is usually recommended in perimesencephalic subarachnoid haemorrhage (PM SAH) to rule out a basilar artery aneurysm. However it is not known how often aneurysms are found among patients with a CT pattern of PM haemorrhage or the frequency of this CT pattern after rupture of posterior circulation aneurysms. METHOD: CTs of all SAH caused by posterior circulation aneurysms admitted from 1/85 to 12/92 where reviewed by two examiners. Late (> 72h) examinations were excluded. The remaining CTs were classified in perimesencephalic (PM) or non PM. RESULTS: 81 posterior circulation aneurysms were collected. Only one PM-like CT pattern was found, due to ruptured posterior communicating artery aneurysm (1.3%; 95% Cl (confidence intervals) = .03-6.7%). During the same period 37 PM SAH with negative angiographic results were admitted. The likelihood of finding an aneurysm in a patient with an early CT showing a PM distribution of haematic densities was 2.7% (95% Cl = .07-.14%). CONCLUSIONS: Although the probability of finding an aneurysm in a SAH patient with a PM CT pattern is low, a complete 4-vessel angiogram must be obtained.
Authors: G J Rinkel; E F Wijdicks; M Vermeulen; L M Ramos; H L Tanghe; D Hasan; L C Meiners; J van Gijn Journal: AJNR Am J Neuroradiol Date: 1991 Sep-Oct Impact factor: 3.825
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Authors: H E Westerlaan; J Gravendeel; D Fiore; J D M Metzemaekers; R J M Groen; J J A Mooij; M Oudkerk Journal: Neuroradiology Date: 2007-09-22 Impact factor: 2.804