scholarly journals The Yield of Repeat Angiography in Angiography-Negative Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 11 (04) ◽  
pp. 565-572 ◽  
Author(s):  
Ujwal Yeole ◽  
Madhusudhan Nagesh ◽  
Dhaval Shukla ◽  
Aravind H. R. ◽  
Prabhuraj A. R.
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Imaging Modality ◽  
Technological Advancement ◽  
Vascular Abnormality ◽  
Institutional Review ◽  
Repeat Angiography ◽  
Noncontrast Computed Tomography ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Eventual Outcome ◽  
Better Than

Abstract Objective Despite the technological advancement in imaging, digital subtraction angiography (DSA) remains gold standard imaging modality for spontaneous subarachnoid hemorrhage (SAH). But even after DSA, around 15% of SAH remains elusive for the cause of the bleed. This is an institutional review to solve the mystery, “when is second DSA really indicated?” Methods In a retrospective review from January 2015 to December 2017, we evaluated cases of spontaneous SAH with initial negative DSA with repeat DSA after 6 weeks to rule out vascular abnormality. The spontaneous SAH was confirmed on noncontrast computed tomography (NCCT) and divided into two groups of perimesencephalic SAH (PM-SAH) or nonperimesencephalic SAH (nPM-SAH). The outcome was assessed by a modified Rankin’s score (mRS) at 6 months postictus. Results During the study period, we had 119 cases of initial negative DSA and 98 cases (82.3%) underwent repeat DSA after 6 weeks interval. A total of 53 cases (54.1%) had PM-SAH and 45 cases (45.9%) had nPM-SAH. Repeat DSA after 6 weeks showed no vascular abnormality in 53 cases of PM-SAH and in 2 (4.4%) out of 45 cases of nPM-SAH. At 6 months postictus, all cases of PM-SAH and 93% of nPM-SAH had mRS of 0. Conclusion We recommend, a repeat DSA is definitely not required in PM-SAH, but it should be done for all cases of nPM-SAH, before labeling them as nonaneurysmal SAH. Although the overall outcome for nonaneurysmal spontaneous SAH is better than aneurysmal SAH, nPM-SAH has poorer eventual outcome compared to PM-SAH.

scholarly journals Prognosis of Patients Victim of Spontaneous Subarachnoid Hemorrhage: A Comparison between Radiologic Scales

2020 ◽  
Vol 39 (01) ◽  
pp. 001-004
Author(s):  
Luiza Maria Dias Abboud Hanna ◽  
Sarah Eloisa Biguelini ◽  
Francisco Alves de Araujo Junior ◽  
Anderson Matsubara ◽  
Pedro Helo dos Santos Neto
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Medical Records ◽  
Early Mortality ◽  
Clinical Scale ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Life Habits ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
The City ◽  
Better Than

Abstract Objective To analyze the population and the early mortality rate (up to thirty days) of patients victim of spontaneous subarachnoid hemorrhage (SAH) according to the Hunt-Hess clinical scale and the Fisher and modified Fisher radiological scales. Materials and Methods We analyzed 46 medical records and skull computed tomography (CT) scans of patients with spontaneous SAH admitted between February 2014 and December 2017 at Hospital Universitário Evangélico Mackenzie, in the city of Curitiba, state of Paraná, Brazil. The method of the study was exploratory-descriptive, transversal and retrospective, with a quantitative approach. We analyzed epidemiological (gender, age), clinical (life habits, pathologies, Glasgow coma scale and Hunt-Hess scale) and radiological (Fisher and modified Fisher scales) variables, and the Hunt-Hess and the Fisher scales were correlated with risk of death. The data was submitted to statistical analysis considering values of p < 0.05. Result There was a higher prevalence of spontaneous SAH among women (69.5%), as well as among patients aged between 51 and 60 years (34.7%). Regarding the grades on the scales, there was higher prevalence of Fisher 4, Modified Fisher 4 and Hunt-Hess 2. Evolution to death was higher among women (76.4%) and patients aged between 61 and 70 years (35,2%). Conclusion Mortality was higher among patients classified as Fisher 3, Modified Fisher 4 and Hunt-Hess ≥ 3. The Fisher scale is better than the modified Fisher scale to assess the risk of mortality.

Spontaneous subarachnoid hemorrhage and negative cerebral panangiography

1986 ◽  
Vol 64 (4) ◽  
pp. 537-542 ◽  
Author(s):  
Mark S. M. Alexander ◽  
P. S. Dias ◽  
David Uttley
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Loss Of Consciousness ◽  
Clinical Grade ◽  
Content Type ◽  
Subarachnoid Blood ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Eventual Outcome ◽  
Basal Cisterns ◽  
Fine Print

✓ One hundred and forty consecutive patients who sustained proven spontaneous subarachnoid hemorrhage (SAH) with negative cerebral panangiography were studied retrospectively. Attention was directed to the presence, amount, and distribution of subarachnoid blood on computerized tomography (CT) scans. It was determined that the finding of blood on CT had a significant association with clinical grade, loss of consciousness, ventricular ratio, fixed ischemic deficit, and total of all complications, but not with epilepsy, hypertension (previously known or detected on admission), treated hydrocephalus, rebleeding, angiographic spasm, and eventual outcome (which was generally excellent on follow-up examination). The distribution of blood, predominantly around the basal cisterns, suggests leakage from ventriculostriate and thalamoperforating vessels as the cause of SAH, and closer study of these vessels is suggested.

Imaging Approach to the Diagnosis of Acute Appendicitis in a Group of Teaching Hospitals with 24/7 In-house Availability of Ultrasound Technologist: Effect of Timing of Request on Imaging Modality

2018 ◽  
Vol 69 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Hassan Alzahrani ◽  
Babak Maghdoori ◽  
Shadman Islam ◽  
Sara Maghdoori ◽  
Mostafa Atri
Keyword(s):  
Acute Appendicitis ◽  
Imaging Modality ◽  
Teaching Hospitals ◽  
Chi Square ◽  
University Of Toronto ◽  
Institutional Review ◽  
After Hours ◽  
Initial Choice ◽  
Determine Effect ◽  
Better Than

Purpose The study sought determine effect of requisition timing on the initial-choice imaging modality in appendicitis evaluation. Methods This was an institutional review board–approved retrospective study, encompassing 3 University of Toronto teaching hospitals, offering 24/7 radiology coverage. All surgically proven appendicitis cases, from 2012-2014, were included and presurgical ultrasound (US) or computed tomography (CT) reports were analysed. Examinations were all requested by the emergency department, performed by the same technologists and reviewed or finalized by the same radiology group (residents fellows or attending). Two coverage categories, namely regular hours (8 am-5 pm, Monday-Friday) or after hours (5 pm-8 am, Monday-Friday and weekends) were compared. The percentage of the starting modality (US or CT), the rate of CT following an indeterminate US, and the sensitivity of each modality was compared between the 2 categories, utilising Mann-Whitney U and chi-square tests. Results Presurgical US or CT studies of 494 patients, from February 2012-August 2014, were evaluated. Regular-hours and after-hours coverage demonstrated 174 (89:85 women:men) and 320 (141:179 women:men; P < .04) patients. The average age, 37.9 ± 17.1 women versus 35.2 ± 13.7 men was not statistically different ( P = .8). Regular hours included 89 of 174 (51.1%) of US-only examinations, 50 of 174 (29%) of CT-only examinations, and 35 of 174 (20%) of US examinations followed by CT examinations. After hours included 147 of 320 (46%) of US-only examinations, 147 of 320 (46%) of CT-only examinations, and 26 of 320 (8%) of US examinations followed by CT examinations ( P < .001). The total diagnostic sensitivities for US and CT were 86% (81% regular hours, 90% after hours; P = .041) and 99.2% (100% regular hours, 99% after hours; P > .05), respectively. Conclusions US was less utilised in acute appendicitis detection after hours, although its diagnostic sensitivity was better than regular-hours coverage.

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

The symptomatology with the most severe clinical course of spontaneous subarachnoid hemorrhage

1979 ◽  
Vol 222 (2) ◽  
pp. 119-129 ◽  
Author(s):  
H. Binder ◽  
F. Gerstenbrand ◽  
K. Jellinger ◽  
J. Krenn ◽  
C. Watzek
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Course ◽  
Spontaneous Subarachnoid Hemorrhage

Value of repeat-angiography in cases of unexplained subarachnoid hemorrhage (SAH)

2009 ◽  
Vol 93 (5) ◽  
pp. 366-373 ◽  
Author(s):  
A. Kaim ◽  
M. Proske ◽  
E. Kirsch ◽  
A. Weymarn ◽  
E-W Radü ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Repeat Angiography

Spontaneous Subarachnoid Hemorrhage and Glucose Management

2011 ◽  
Vol 15 (2) ◽  
pp. 281-286 ◽  
Author(s):  
Erich Schmutzhard ◽  
◽  
Alejandro A. Rabinstein
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Glucose Management

AUREOMYCIN IN STAPHYLOCOCCIC MENINGITIS COMPLICATING SUBARACHNOID HEMORRHAGE IN SICKLE CELL ANEMIA

PEDIATRICS ◽  
1949 ◽  
Vol 3 (6) ◽  
pp. 764-768
Author(s):  
JOHN R. ALMKLOV ◽  
ARILD E. HANSEN
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Therapeutic Agent ◽  
In Vitro Studies ◽  
Neurologic Complications ◽  
Rare Occurrence ◽  
Laboratory Findings ◽  
Spontaneous Subarachnoid Hemorrhage

The rare occurrence of a spontaneous subarachnoid hemorrhage in an 11 year old Negro boy with sickle cell anemia is recorded. Of the eight reported cases five have occurred in children. In the study of sickle cell anemia it is evident there is an increasing awareness of this as well as other neurologic complications. This patient developed staphylococcus albus meningitis which for 12 days resisted combined penicillin, streptomycin and sulfadiazine therapy. The response to aureomycin as a sole therapeutic agent was dramatic, and this represents the first reported case of meningitis treated with this drug. The use of aureomycin as the only antibiotic in this staphylococcic infection seems to have been fortunate in view of the laboratory findings. In vitro studies disclosed that when penicillin and aureomycin or streptomycin and aureomycin were combined, the result was a decrease in the effectiveness of either drug on staphylococci.

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