Advances in the management of patients with spontaneous subarachnoid hemorrhage with negative first angiography
Journal Title: Chinese Journal of Nervous and Mental Diseases - Year 2024, Vol 50, Issue 6
Abstract
Spontaneous subarachnoid hemorrhage (sSAH) is one of the common critical illnesses in neurosurgery, and still has a high rate of death and disability. For these patients, computed tomographic angiography (CTA) or digital subtraction angiography (DSA) should be performed as soon as possible to identify the cause and location of the hemorrhage, and surgery should be performed as soon as possible according to the identified cause. This is particularly important to improve the prognosis of patients. However, some patients have false-negative first-time angiograms for a variety of reasons, such as perimesencephalic subarachnoid hemorrhage, microaneurysms, thrombotic aneurysms, intracranial vascular malformations, spinal vascular malformations, and the experience of the radiologists. Patients with a negative first imaging must be followed up, especially in patients with a high suspicion of aneurysm on CT scanning of the head after onset. The time of the reexamination is recommended to be in the early (<2 weeks) and mid-term (2-8 weeks) stages after the disease, and to increase the vigilance and ability to recognize microvascular lesions, and to improve the ability of first-time detection of the cause with the help of the latest imaging techniques.
Authors and Affiliations
HUANG Qinjiang,LI Rui,LI Wenyong,WAN Chunyou,HONG Wei,
Keywords
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