Diagnostic value of magnetic resonance imaging in perimesencephalic and nonperimesencephalic subarachnoid hemorrhage of unknown origin

Maslehaty, Homajoun; Petridis, A. K.; Barth, Harald; Mehdorn, H. Maximilian

doi:10.3171/2010.6.jns10310

Cited by 60 publications

(30 citation statements)

References 19 publications

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“…The role of magnetic resonance imaging in perimesencephalic aSAH is controversial. 104 Indications for magnetic resonance angiography in aSAH are still few because of limitations with routine availability, logistics (including difficulty in scanning acutely ill patients), predisposition to motion artifact, patient compliance, longer study time, and cost. Aneurysms Ͻ3 mm in size continue to be unreliably demonstrated on computed tomographic angiography (CTA), 105,106 and this generates continued controversy in the case of CTA-negative aSAH.…”

Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Connolly¹,

Rabinstein²,

Carhuapoma³

et al. 2012

Stroke

2,957

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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Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Connolly¹,

Rabinstein²,

Carhuapoma³

et al. 2012

Stroke

2,957

1,375

View full text Add to dashboard Cite

show abstract

“…Current controversies also include the necessity and diagnostic yield of further neuroimaging modalities in the clinical course of NNSAH, including repeat cranial DSA, cranial and spinal magnetic resonance imaging (MRI) and CT or MR-angiography (4,18,41,53).…”

mentioning

confidence: 99%

Clinical course of nontraumatic nonaneurysmal subarachnoid hemorrhage: a single institution experience over 10 years and review of the contemporary literature

Akçakaya

Aydöseli²,

Aras³

et al. 2016

Turkish Neurosurgery

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ABSTRACTof patients with non-traumatic subarachnoid hemorrhage, no underlying cause was detected on initial four to six vessel digital subtraction angiography (DSA) (13,21,31,48,52,54).Although the clinical course of non-traumatic non-aneurysmal subarachnoid hemorrhage (NNSAH) has been reported to be █ INTRODUCTION T he majority of non-traumatic subarachnoid hemorrhage (SAH) events are caused by the rupture of saccular aneurysms, which are associated with significant morbidity and mortality (16). However, in approximately 15% AIM: To report our experience with a relatively large series of patients with non-traumatic non-aneurysmal subarachnoid hemorrhage (NNSAH) to identify the prognosis associated with different bleeding patterns as well as a further diagnostic work-up to determine the underlying cause. MATERIAL and METHODS:Between January 2004 and December 2014, 81 patients with angiography-negative non-traumatic subarachnoid hemorrhage (SAH) were treated at our institution. Diagnosis was confirmed with a typical history of spontaneous SAH and cranial computed tomography (CT) scan or lumbar puncture (LP). The patients were grouped according to the bleeding pattern on the CT scan: Group 1: Perimesencephalic (PM) SAH (n=33, 40.7%); Group 2: Non-perimesencephalic (nPM) SAH (n=41, 50.6%); and Group 3: CT-negative NNSAH (n=7, 8.6%). The clinical course, hospitalization period, and complications were noted. All patients underwent an initial four-vessel digital subtraction angiography (DSA). Cranial magnetic resonance imaging (MRI), repeat DSA investigations and spinal MRI were performed in all patients. RESULTS:The mean hospital stays were 6.3, 14.7 and 10.1 days for patient groups 1, 2, and 3, respectively. The mortality rate was 1.2% (1 patient) in our series. Repeat DSA investigations were positive in two patients (2.5%), both from Group 2 (4.9%). Cranial MRI revealed 100% negative results. Spinal MRI revealed positive results in three patients from Group 2 (7.3%). CONCLUSION:We suggest our diagnostic work-up for patients with nPM-SAH, namely repeat DSA and spinal MRI, until an evidence-based guideline is established for the patient management.

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“…It is accepted that MRI can detect lesions such as pituitary apoplexy and superficial cavernomas that are hard to demonstrate on other modalities, but the yield of this additional imaging also appears to be very low in most published series [24,25]. Spinal MR imaging is routinely performed in some centers with a view to demonstrating an intraspinal vascular malformation or hemorrhagic intradural tumor.…”

Section: Mr Imagingmentioning

confidence: 95%