CT Findings of Spontaneous Subarachnoid Hemorrhage of Unknown Cause

PURPOSE: Spontaneous subarachnoid hemorrhage(S-SAH) is a relatively rare disease with good clinical course and prognosis. The purpose of this study is to evaluate the cisternal blood distribution on CT in patient with S-SAH. MATERIALS AND METHODS: Out of 406 patients with subarachnoid hemorrhage on brain CT scan, 11 patients confirmed to be S-SAH by angiography and clinical follow-up were examined. We analysed the CT findings of these 11 cases retrospectively. RESULTS: Five patients had only perimesencephalic distribution of hemorrhage:the prepontine, the interped- uncular, and the suprasellar cisterns were involved in 4 cases each, the basal sylvian cistern in 3 cases, and the ambient cistern in 2 cases. The quadrigeminal and a portion of the lateral sylvians were also involved in 1 case each. Six patients revealed cisternal hemorrhage extending beyond the perimesencephalic cistern into the ventricles, cortical sulci, and lateral sylvian fissure. Intraventricular hemorrhage was noted in 3 cases of these 6 patients. CONCLUSION: Our study suggests that uncomplicated clinical course and normal anglographic finding are more important than CT distribution of cisternal hemorrhage in diagnosing S-SAH.

Percutaneous Ethanol Ablation of Hepatic and Renal Cyst: Therapeutic Effect and Follow-Up Study

PURPOSE: To evaluate the ability of percutaneous ethanol ablation in the treatment of benign cysts of the liver and kidney, and to decide the need and the time of retreatment when the cysts remain on the follow-up ultrasonogram. MATERIALS AND METHODS: Twenty benign cysts(8 hepatic and 12 renal cysts) in 18 patients diagnosed or confirmed either by ultrasound, CT or cytology were treated with percutaneous ethanol injection(PEI). After evacuation of cystic fluid, 15-900ml(amount corresponding to 40-50% of the volume of aspirated fluid) of absolute ethanol(99.9%) was injected into the cysts through the aspiration catheter. rln large cysts, two or more PEIs were done in one session. Follow-up ultrasonographic studies during the period of 12 months with 1-2 months interval after PEI were performed for evaluation of the therapeutic effect. RESULTS: Nine cysts(45%) disappeared completely within 2 months after initial PEI. Although 11 cysts(55.5%) recurred 2 months after initial PEI, 8 of them disappeared within 6 months and one within 8 months after inital PEI without additional PEI. As a result, 18 of 20 cysts(90%) disappeared within 8 months after initial PEI and most of the recurrent cysts disappeared within 6 months without additional PEI. No major complications were encountered concerning PEI, although transient abdominal pain, elevation of body temperature, and drowsiness were noted in 8 patients. CONCLUSION: PEI is an effective and safe modality for the treatment of benign hepatic or renal cysts and the apparent recurrence within 6 months after initial PEI might be mostly a transient, reactive or inflammatory fluid collection rather than real recurrence.