Computed Tomographic Angiography for Cerebral Aneurysms in Spontaneous Subarachnoid Hemorrhage

• Main Authors: Djalma Felipe da Silva Menéndez, Hugo Sterman Neto, Marcos de Queiroz Teles Gomes, Suzana Jaíze Alves, Wellingson Silva Paiva, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2016-05-01
• Series: Brazilian Neurosurgery
• Subjects: computed tomographic angiography; digital subtraction angiography; intracranial aneurysm; subarachnoid hemorrhage
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1584203
• ISSN: 0103-5355; 2359-5922

Abstract Computed tomographic angiography (CTA) has recently gained popularity as an initial imaging test for spontaneous subarachnoid hemorrhage (SAH). This study evaluated 59 patients presenting aneurysmal SAH who underwent microsurgical clipping based on CTA findings alone and digital subtraction angiography (DSA) at postoperative follow-up. Multiple aneurysms were identified by CTA in 27% of patients and in 10% of patients, DSA identified aneurysms in addition to those diagnosed with CTA. The time between CTA and surgical treatment ranged from 0–4 days. Postoperative DSA revealed that 24% of patients had residual neck. The use of CTA alone may not be enough to detect small unruptured aneurysms in patients with multiple lesions or aneurysm remnants adjacent to an aneurysm clip. However, the advantages of CTA compared with DSA include its rapidity, reduced invasiveness, and lower cost, which allow us to proceed to ruptured aneurysm repair entirely on the basis of good-quality CTA studies.