Document Detail

The use of clinical and routine imaging data to differentiate between aneurysmal and nonaneurysmal subarachnoid hemorrhage prior to angiography. Clinical article.
MedLine Citation:
PMID:  20486897     Owner:  NLM     Status:  MEDLINE    
OBJECT: In this study, the authors' goal was to minimize false-negative results in the detection of ruptured cerebral aneurysms. METHODS: The authors retrospectively reviewed the clinical and radiological information in consecutive adult patients admitted with acute subarachnoid hemorrhage (SAH) to their hospital between January 1, 2002, and January 1, 2008. Patients were grouped based on the presence or absence of a ruptured aneurysm, which was detected by catheter angiography. Multivariate logistic regression analysis was used to identify factors predicting detection of aneurysmal rupture by angiography. RESULTS: The authors identified 199 patients (121 women [61%]). A ruptured aneurysm was detected in 167 patients (84%). In multivariate analysis, loss of consciousness at the onset of SAH was a strong predictive factor associated with detection of a ruptured aneurysm on subsequent angiography (OR > 100, p = 0.0002). The positive predictive value of loss of consciousness at the onset of SAH for detection of a ruptured aneurysm was 100%. CONCLUSIONS: Loss of consciousness at the onset of SAH is highly predictive of aneurysm rupture. A negative CT angiography study in these patients may be a false result, and a high-quality catheter angiography should be performed.
Stefan A Dupont; Giuseppe Lanzino; Eelco F M Wijdicks; Alejandro A Rabinstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  113     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  790-4     Citation Subset:  AIM; IM    
Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Aneurysm, Ruptured / diagnosis
Cerebral Angiography
Diagnosis, Differential
False Negative Reactions
Logistic Models
Middle Aged
Predictive Value of Tests
Subarachnoid Hemorrhage / diagnosis*

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