The Use of Hounsfield Units on Initial Computed Tomography Scan of the Head to Rule Out a Subarachnoid Hemorrhage

2005 ◽  
Vol 12 (Supplement 1) ◽  
pp. 53-53
Author(s):  
M. Al-Salamah
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Scan ◽  
Hounsfield Units ◽  
Tomography Scan ◽  
Rule Out

scholarly journals Computed tomography grading schemes used to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a historical review

2006 ◽  
Vol 21 (3) ◽  
pp. 1-8 ◽  
Author(s):  
Paul Klimo ◽  
Richard H. Schmidt
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Historical Review ◽  
Science Research ◽  
Computed Tomography Scan ◽  
Major Area ◽  
Volumetric Quantification ◽  
Tomography Scan

✓The elucidation of predictive factors of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major area of both clinical and basic science research. It is becoming clear that many factors contribute to this phenomenon. The most consistent predictor of vasospasm has been the amount of SAH seen on the postictal computed tomography scan. Over the last 30 years, it has become clear that the greater the amount of blood within the basal cisterns, the greater the risk of vasospasm. To evaluate this risk, various grading schemes have been proposed, from simple to elaborate, the most widely known being the Fisher scale. Most recently, volumetric quantification and clearance models have provided the most detailed analysis. Intraventricular hemorrhage, although not supported as strongly as cisternal SAH, has also been shown to be a risk factor for vasospasm.

scholarly journals The Relationship Between Delayed Infarcts and Angiographic Vasospasm After Aneurysmal Subarachnoid Hemorrhage

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 702-708 ◽  
Author(s):  
Robert J. Brown ◽  
Abhay Kumar ◽  
Rajat Dhar ◽  
Tomoko R. Sampson ◽  
Michael N. Diringer
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Infarct Volume ◽  
Delayed Cerebral Ischemia ◽  
Computed Tomography Scan ◽  
Angiographic Vasospasm ◽  
Arterial Vasospasm ◽  
The Relationship ◽  
Tomography Scan

Abstract BACKGROUND: Delayed cerebral ischemia is common after aneurysmal subarachnoid hemorrhage (aSAH) and is a major contributor to poor outcome. Yet, although generally attributed to arterial vasospasm, neurological deterioration may also occur in the absence of vasospasm. OBJECTIVE: To determine the relationship between delayed infarction and angiographic vasospasm and compare the characteristics of infarcts related to vasospasm vs those unrelated. METHODS: A retrospective review of patients with aSAH admitted from July 2007 through June 2011. Patients were included if they were admitted within 48 hours of SAH, had a computed tomography scan both 24 to 48 hours following aneurysm treatment and ≥7 days after SAH, and had a catheter angiogram to evaluate for vasospasm. Delayed infarcts seen on late computed tomography but not postprocedurally were attributed to vasospasm if there was moderate or severe vasospasm in the corresponding vascular territory on angiography. Infarct volume was measured by perimeter tracing. RESULTS: Of 276 aSAH survivors, 134 had all imaging requisite for inclusion. Fifty-four (34%) had moderate or severe vasospasm, of whom 17 (31%) had delayed infarcts, compared with only 3 (4%) of 80 patients without vasospasm (P < .001). There were a total of 29 delayed infarcts in these 20 patients; 21 were in a territory with angiographic vasospasm, but 8 (28%) were not. Infarct volume did not differ between vasospasm-related (18 ± 25 mL) and vasospasm-unrelated (11 ± 12 mL) infarcts (P = .54), but infarcts in the absence of vasospasm were more likely watershed (50% vs 10%, P = .03). CONCLUSION: Delayed infarcts following aSAH can occur in territories without angiographic vasospasm and are more likely watershed in distribution.

Fate of Clots in Patients With Subarachnoid Hemorrhage After Different Surgical Treatment Modality: A Comparison Between Surgical Clipping and Guglielmi Detachable Coil Embolization

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 966-973 ◽  
Author(s):  
Satoshi Shirao ◽  
Hiroshi Yoneda ◽  
Hideyuki Ishihara ◽  
Kei Harada ◽  
Katsuhiko Ueda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Coil Embolization ◽  
Computed Tomography Scan ◽  
Surgical Clipping ◽  
Detachable Coil ◽  
Symptomatic Vasospasm ◽  
Guglielmi Detachable Coil ◽  
Embolization Coil ◽  
Tomography Scan

Abstract BACKGROUND: Subarachnoid clot is important in the development of delayed vasospasm after subarachnoid hemorrhage (SAH). OBJECTIVE: To compare the clearance of subarachnoid clot and the incidence of symptomatic vasospasm in surgical clipping and embolization with Guglielmi detachable coils for aneurysmal SAH. METHODS: The subjects were 115 patients with Fisher group 3 aneurysmal SAH on computed tomography scan at admission whose aneurysm was treated by surgical clipping (clip group; n = 86) or Guglielmi detachable coil embolization (coil group; n = 29) within 72 hours of ictus. Software-based volumetric quantification of the subarachnoid clot was performed, and the amount of hemoglobin in drained cerebrospinal fluid was measured. RESULTS: Clearance of the subarachnoid clot on the computed tomography scan was rapid in the clip group until the day after the operation but slow in the coil group (58.9% removed vs 27.8% removed; P = .008). However, postoperative clearance of the clot occurred more rapidly in the coil group. Reduction of the clot until days 3 through 5 did not differ significantly between the 2 groups (72.9% removed vs 75.2% removed). The amount of hemoglobin in the clip group was > 0.8 g/d until day 3 and then gradually decreased (n = 15), but hemoglobin in the coil group remained at > 0.8 g/d until day 5 (n = 17). The incidence of symptomatic vasospasm did not differ between the groups. CONCLUSION: Subarachnoid clot can be removed directly during surgical clipping, which is not possible with endovascular treatment. However, the percentage reduction of the clot on days 3 through 5 did not differ between the 2 groups.

Sweet Nothings

2020 ◽  
pp. 259-262
Author(s):  
Pat Croskerry
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Potential Benefit ◽  
Community Hospital ◽  
Correct Diagnosis ◽  
Young Female ◽  
Computed Tomography Scan ◽  
Routine Blood ◽  
History Of ◽  
Tomography Scan

In this case, a young female presents to a community hospital complaining of headache. She has a history of migraine and reports that this headache feels typical. Routine blood work is drawn, and treatment is begun for her headache. However, before it is initiated, she has a seizure and is rendered comatose. A diagnosis of subarachnoid hemorrhage is made. She is intubated and transferred to another hospital for a computed tomography scan of her head. In the meantime, her blood work is returned, which reveals the cause of her seizure and her correct diagnosis. The case illustrates the potential benefit of medical caveats (cognitive forcing strategies).

scholarly journals Hemophagocytic syndrome in a patient with disseminated tuberculosis: a case report

2018 ◽  
Vol 12 (1) ◽  
pp. 61 ◽  
Author(s):  
Vania Lombardo ◽  
Fania Puccia ◽  
Antonino Terranova ◽  
Andrea Affronti ◽  
Ada Maria Florena ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Genetic Background ◽  
Hemophagocytic Syndrome ◽  
Malignant Diseases ◽  
Computed Tomography Scan ◽  
Antituberculous Therapy ◽  
Disseminated Tuberculosis ◽  
Tomography Scan ◽  
Rule Out

Hemophagocytic syndrome (HS) is a rare disorder of the immune system. It is characterized by fever, lymphadenopathy, hepatosplenomegaly, cytopenia and hyperferritinemia. The cause differs in each country suggesting a specific genetic background and epidemiology of infections, and it can be associated with malignant diseases. A rare cause of HS is tuberculosis (TB), we describe a case of HS associated with disseminated Mycobacterium tuberculosis (MT) infection in a patient from Sudan. He presented diarrhea, fever, pancytopenia, thickened and dilated bowel loops and lymph nodes enlargement at ultrasound and computed tomography scan. A bone marrow biopsy performed to rule out a lymphoma revealed a HS. The bronchoalveolar lavage (BAL) culture was then positive for MT and subsequently, radiologic aspects of lung and spleen TB involvement appeared. A disseminated tuberculosis was diagnosed. Despite antituberculous therapy, the patient died as in approximately 50% of the HS associated with TB.

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