Erlaubt die Computertomographie nach aneurysmatischer Subarachnoidalblutung die korrekte Vorhersage der Aneurysmalokalisation?
| Autor: | H. Bertalanffy, Joachim M. Gilsbach, Michael Mull, L. Mayfrank, V. Rohde |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
Subarachnoid hemorrhage medicine.diagnostic_test business.industry Vertebral artery Pericallosal Artery medicine.disease Surgery Anterior communicating artery Aneurysm medicine.artery Angiography cardiovascular system Basilar artery Medicine cardiovascular diseases Neurology (clinical) Radiology Internal carotid artery business |
| Zdroj: | Zentralblatt für Neurochirurgie. 64:116-122 |
| ISSN: | 1438-9746 0044-4251 |
| DOI: | 10.1055/s-2003-41882 |
| Popis: | OBJECTIVE To investigate if the intracisternal distribution of subarachnoid hemorrhage (SAH) following aneurysm rupture allows the correct prediction of the symptomatic aneurysm site. [nl] METHODS Ninety-nine consecutive patients with acute SAH and angiographically proven aneurysm were included into the study. The parent vessel of the diagnosed aneurysms were the anterior communicating artery (ACoA) in 38 patients, the middle cerebral artery (MCA) in 26 patients, the internal carotid artery (ICA) in 25 patients, the pericallosal artery (A2) in 5 patients, the basilar artery (BA) in 4 patients and the vertebral artery (VA) in 1 patient. In 21 patients, an additional asymptomatic aneurysm was diagnosed. The initial computerized tomography (CT) scans of the 99 patients were given to 2 experienced vascular neurosurgeons, who were blinded for the angiography findings. The 2 investigators had to predict the site of the ruptured aneurysm. [nl] RESULTS Investigator 1 correctly predicted the aneurysm site in 56 (57 %), investigator 2 in 59 of the 99 patients (60 %). Investigator 1 correctly identified 81 % of the MCA aneurysms, and investigator 2 74 % of the ACoA aneurysms. However, in only 46 of the 99 patients (47 %), the aneurysm site was correctly predicted by both investigators together. [nl] CONCLUSION The results indicate, that the distribution of the subarachnoid blood as shown on the first CT scan after aneurysm rupture barely allows to predict the symptomatic aneurysm site. Thus, neurosurgical decision making (identification of the ruptured aneurysm in patients with multiple aneurysms; surgical exploration in patients with non-perimesencephal SAH, but negative angiography) should not rely on the first CT scan after SAH. |
| Databáze: | OpenAIRE |
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