Clinical and CT Characteristics of SAH with no Aneurysm Visualized on the First Angiogram

J Korean Neurol Assoc > Volume 8(2); 1990 > Article

Journal of the Korean Neurological Association 1990;8(2): 212-219.

혈관조영술상 동맥류가 발견되지 않은 자발성 지주막하출혈의 임상 및 CT소견의 특징에 대한 연구

정진상, 한문강, 김 제, 위봉애

충남대학교 신경과. 서울대학교 신경과.

Clinical and CT Characteristics of SAH with no Aneurysm Visualized on the First Angiogram

Chin Sang Chung, M.D., Moon Gang Han, M.D, Jei Kim, M.D., Bong Ae Wie*, M.D.

Department of Neurology College of Medicine Chunnam National University and Seoul National University*

Abstract

A retrospective study was performed to provide the clinical and radiological grounds for decision-making as to whether the next cerebral angiography is to be followed when no aneurysm is revealed on the first procedure in patients with spontaneous subarachnoid hemorrhage. Thc clinical courses of 22 patients who showed no aneurysm on their first angiogram(unproven group) were compared with those of 19 patients of the similar clinical status whose aneurgsm(s) was/were proven but not operated(non-operated group). The results were 1)The incidences of vasospasm, hydrocephalus, electrolyte disturbances, infections, and gastrointestinal bleeding were similar between the groups; 2)Rebleeding was Iess frequent in thc unproven group(p<.05); 3) Neurological outcomes were also significantly beffer in the unproven group(p<.018; 4) The distributions of blood clots in the subarachnoid space were less predictive of aneurysmal site in the unproven group. Considering thc better prognosis and the nonspecific CT findings of the unproven group, our results suggest that when no aneurysm is demonstrated on the first angiogram, the repeated angiography may not be necessary.