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

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.