Radiological analysis of subarachnoid hemorrhage from ruptured intracranial aneurysms

1988 ◽  
Vol 24 (1) ◽  
pp. 48
Author(s):  
J D Lee ◽  
J H Suh ◽  
D I Kim
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Ruptured Intracranial Aneurysms ◽  
Radiological Analysis

Aneurysmal Subarachnoid Hemorrhage: Neurosurgical Frontiers and Nursing Challenges

1991 ◽  
Vol 2 (4) ◽  
pp. 665-674
Author(s):  
Helen A. Cook
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Seizure Activity ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Treatment Strategies ◽  
Mortality Rates ◽  
Aneurysmal Rupture ◽  
Management Of Complications ◽  
Ruptured Intracranial Aneurysms

Despite increases in survival beyond the initial hemorrhage, the devastating consequences of subarachnoid hemorrhage persist. Ruptured intracranial aneurysms are the most likely cause of subarachnoid hemorrhage, with morbidity and mortality rates approaching 75%. Complications arising from aneurysmal subarachnoid hemorrhage include rebleeding, delayed cerebral ischemia, hydrocephalus, hypothalamic dysfunction, and seizure activity. In order to positively influence outcome after subarachnoid hemorrhage, preservation of an adequate cerebral blood flow and prevention of secondary aneurysmal rupture is essential. This article reviews aneurysmal subarachnoid hemorrhage, relating the management of complications to currently accepted treatment strategies

scholarly journals Comprehensive review of imaging of intracranial aneurysms and angiographically negative subarachnoid hemorrhage

2019 ◽  
Vol 47 (6) ◽  
pp. E20 ◽  
Author(s):  
Brian M. Howard ◽  
Ranliang Hu ◽  
Jack W. Barrow ◽  
Daniel L. Barrow
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Best Practices ◽  
Intracranial Aneurysms ◽  
Vascular Lesion ◽  
Reference Standard ◽  
Unruptured Intracranial Aneurysm ◽  
Imaging Protocols ◽  
Ruptured Intracranial Aneurysms

Intracranial aneurysms confer the risk of subarachnoid hemorrhage (SAH), a potentially devastating condition, though most aneurysms will remain asymptomatic for the lifetime of the patient. Imaging is critical to all stages of patient care for those who harbor an unruptured intracranial aneurysm (UIA), including to establish the diagnosis, to determine therapeutic options, to undertake surveillance in patients who elect not to undergo treatment or whose aneurysm(s) portends such a low risk that treatment is not indicated, and to perform follow-up after treatment. Neuroimaging is equally as important in patients who suffer an SAH. DSA remains the reference standard for imaging of intracranial aneurysms due to its high spatial and temporal resolution. As noninvasive imaging technology, such as CTA and MRA, improves, the diagnostic accuracy of such tests continues to increasingly approximate that of DSA. In cases of angiographically negative SAH, imaging protocols are necessary not only for diagnosis but also to search for an initially occult vascular lesion, such as a thrombosed, ruptured aneurysm that might be detected in a delayed fashion. Given the crucial role of neuroimaging in all aspects of care for patients with UIAs and SAH, it is incumbent on those who care for these patients, including cerebrovascular neurosurgeons, interventional neurologists and neuroradiologists, and diagnostic radiologists and neurointensivists, to understand the role of imaging in this disease and how individual members of the multispecialty team use imaging to ensure best practices to deliver cutting-edge care to these often complex cases. This review expounds on the role of imaging in the management of UIAs and ruptured intracranial aneurysms and in the workup of angiographically negative subarachnoid hemorrhage.

EVALUATING IMAGING FEATURE ON CTA AND DSA OF RUPTURED CEREBRAL ANEURYSMS

2017 ◽  
pp. 14-20
Author(s):  
Thanh Vu Huynh ◽  
Van Ngoc Cuong Le
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Imaging Feature ◽  
Key Words Aneurysm ◽  
Diagnostic Efficacy ◽  
Imaging Characteristics ◽  
The Difference ◽  
Ruptured Intracranial Aneurysms

Objective: To compare the imaging feature of ruptured intracranial aneurysms on CTA and DSA. Material and Methods: From April 2016 to June 2017, 33 cases with SAH was performed CTA and DSA to all cases. The results of the CTA were compared with the DSAresults to determine the diagnostic efficacy of CTA in evaluating characterizations of ruptured cerebral aneurysms. Results: The difference is not statistically significant between CTA and DSA in evaluating of aneurysm size, location, rupture status, and other imaging characteristics. Conclusion: CTA is invaluable in evaluatingruptured cerebral aneurysms that guide clinicians to make planning the treatment. Key words: aneurysm, rupture, subarachnoid, hemorrhage

Safety and Efficacy of Endovascular Embolization of Ruptured Intracranial Aneurysms within 72 hours of Subarachnoid Hemorrhage

2021 ◽  
Author(s):  
Xin-Yu Li ◽  
Cong-Hui Li ◽  
Ji-Wei Wang ◽  
Jian-Feng Liu ◽  
Hui Li ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Endovascular Embolization ◽  
Safety And Efficacy ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Ruptured Intracranial Aneurysms

Abstract Purpose The purpose of the study was to investigate the safety and efficacy of endovascular embolization of ruptured intracranial aneurysms within 72 hours of subarachnoid hemorrhage (SAH). Materials and methods Patients with intracranial aneurysms treated with embolization were divided into group A (n = 277), patients with ruptured aneurysms treated within 72 hours of SAH; group B (n = 138), patients with ruptured aneurysms treated beyond 72 hours; and group C (n = 93), patients with unruptured aneurysms. Results Embolization was successful in all but four patients (99.2%). The periprocedural complication rate was 36.2% in group B, significantly (p < 0.05) greater than that in group A (24.5%) or group C (11.8%). The rebleeding rate was 9.7% (6/62 patients) in groups A and B after embolization and only 0.3% (1/346 patients) in aneurysms with total or subtotal occlusion. Of these three groups of patients, 69.7% in group A, 58.7% in group B, and 76.3% in group C achieved Glasgow Outcome Scale (GOS) score of 5 or modified Rankin Scale (mRS) score of 0– to 1 at discharge. A significant difference (p < 0.05) existed in the clinical outcome between the three groups. The percentages of patients without deficits (GOS 5 or mRS 0–1) and slight disability (mRS 2) were 80.2% in group A, 81.2% in group B, and 96.7% in group C. The mortality rate was 4.3% (12/277 patients) in group A and 7.2% (10/138 patients) in group B with no significant (p = 0.21) difference. Follow-up was performed at 3 to 54 months (mean 23.2), and the recanalization rate was 28.6% (32/112 patients) in group A, 22.4% (11/49 patients) in group B, and 28.6% (16/56 patients) in group C, with no significant differences (p = 0.15). Hydrocephalus occurred in 30.5% (39/128 patients) in group B, which was significantly (p < 0.01) greater than that in group A (9.4%) or group C (2.2%). Conclusion Early embolization of ruptured cerebral aneurysms within 72 hours of rupture is safe and effective and can significantly decrease periprocedural complications compared with management beyond 72 hours. Timely management of cisternal and ventricular blood can reduce hydrocephalus incidence and improve prognosis.

Hydrocephalus and Vasospasm after Subarachnoid Hemorrhage from Ruptured Intracranial Aneurysms

1990 ◽  
pp. 155-155
Author(s):  
Ichiro Izawa ◽  
Kazuyoshi Korosue ◽  
Seiji Hamano ◽  
Yoshinori Nagao ◽  
Norihiko Tamaki ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Ruptured Intracranial Aneurysms

scholarly journals Transcranial Doppler Studies in Aneurysm Patients

1989 ◽  
Vol 16 (4) ◽  
pp. 411-416 ◽  
Author(s):  
Kenneth Hutchison ◽  
Bryce Weir
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Transcranial Doppler ◽  
Intracranial Aneurysms ◽  
Transitional Zone ◽  
Progressive Increase ◽  
Doppler Studies ◽  
Unruptured Aneurysms ◽  
Clinical Symptomatology ◽  
Clinically Significant ◽  
Ruptured Intracranial Aneurysms

ABSTRACT:Fifty patients with ruptured intracranial aneurysms and 8 patients with elective clipping of unruptured aneurysms had daily transcranial Doppler (TCD) measurements performed. The highest mean middle cerebral artery velocity (MCA-Vel) was considered to be the best single parameter forjudging a patient's susceptibility to clinically significant vasospasm (VSP). Surgery for the clipping of unruptured aneurysms by itself does not lead to an increase in MCA-Vel. There is a progressive increase in MCA-Vel after subarachnoid hemorrhage (SAH) from aneurysms which peaks between 7 and 10 days. The MCA-Vel is higher on the side of the ruptured aneurysm and the degree of rise is greater if blood is seen on the initial CT scan. It is highly unlikely that a patient whose MCA-Vel remains under 100 cm/sec has a degree of angiographic VSP which causes clinical symptomatology. Patients whose MCA-Vel is > 200 cm/sec are at great risk of developing clinical symptomatology of VSP and are very likely to have significant angiographic VSP. There is a transitional zone in between these two levels.

Comparison of stent-assisted and no-stent coil embolization for safety and effectiveness in the treatment of ruptured intracranial aneurysms

2020 ◽  
Vol 133 (3) ◽  
pp. 814-820 ◽  
Author(s):  
Haewon Roh ◽  
Junwon Kim ◽  
Heejin Bae ◽  
Kyuha Chong ◽  
Jong Hyun Kim ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
High Risk ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Viable Option ◽  
Safety And Efficacy ◽  
Ruptured Aneurysms ◽  
Hemorrhagic Complications ◽  
Acute Subarachnoid Hemorrhage ◽  
Ruptured Intracranial Aneurysms

OBJECTIVEThe safety of the stent-assisted coil embolization (SAC) technique for acutely ruptured aneurysms has not been established yet. SAC is believed to be associated with a high risk of thromboembolic and hemorrhagic complications in acute subarachnoid hemorrhage (SAH). The aim of this study was to evaluate the safety and efficacy of the SAC technique in the setting of acutely ruptured aneurysm.METHODSA total of 102 patients who received endovascular treatment for acute SAH between January 2011 and December 2017 were enrolled. The SAC technique was performed in 38 of these patients, whereas the no-stent coil embolization (NSC) technique was performed in 64. The safety and efficacy of the SAC technique in acute SAH was evaluated as compared with the NSC technique by retrospective analysis of radiological and clinical outcomes.RESULTSThere were no significant differences in clinical or angiographic outcomes between the SAC and NSC techniques in patients with acute SAH. The rate of ventriculostomy-related hemorrhagic complications was higher in the SAC group than that in the NSC group (63.6% vs 12.5%; OR 12.25, 95% CI 1.78–83.94, p = 0.01). However, all these complications were asymptomatic and so small that they were only able to be diagnosed with imaging.CONCLUSIONSRuptured wide-necked aneurysms could be effectively and safely treated with the SAC technique, which showed clinical and angiographic outcomes similar to those of the NSC technique. Hence, the SAC technique with dual-antiplatelet drugs may be a viable option even in acute SAH.

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