Abstract
Not infrequently, cerebral angiography performed immediately after the onset of subarachnoid hemorrhage (SAH) fails to reveal any causative lesion. Although the cause of the SAH in most of these cases remains unknown, repeat angiography sometimes discloses a lesion not detected by the initial angiography. The frequency of finding a ruptured aneurysm by repeat angiography and the angiographic characteristics of such aneurysms have been investigated retrospectively. Nineteen among 316 non-traumatic SAH patients (6%) showed initially negative angiogram, and 7 of 19 patients (36%) were identified as harboring an "initially occult" aneurysm. It was possible to identify the expected cause of these initial false-negative angiograms in four of those seven patients. The aneurysm was located in the anterior communicating artery (ACoA) complex in four of the seven patients. When interpreting the angiograms of patients with SAH, neurologists and neurosurgeons should bear in mind the finding that the ACoA complex is the most frequent site of "initially occult" aneurysms. One patient had a dissecting aneurysm of the internal carotid artery, and although such lesions have been considered rare, they should be included in the differential diagnosis of SAH of unknown origin.
| Original language | English |
|---|---|
| Pages (from-to) | 33-37 |
| Number of pages | 5 |
| Journal | Clinical Neurology and Neurosurgery |
| Volume | 106 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2003 Dec |
| Externally published | Yes |
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Keywords
- Anterior communicating artery
- Dissecting aneurysm
- Occult
- Repeat angiography
- Subarachnoid hemorrhage
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Neurology
Cite this
"Occult" ruptured cerebral aneurysms revealed by repeat angiography : Result from a large retrospective study. / Inamasu, Joji; Nakamura, Yoshiki; Saito, Ryoichi; Horiguchi, Takashi; Kuroshima, Yoshiaki; Mayanagi, Keita; Orii, Maaya; Ichikizaki, Kiyoshi.
In: Clinical Neurology and Neurosurgery, Vol. 106, No. 1, 12.2003, p. 33-37.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - "Occult" ruptured cerebral aneurysms revealed by repeat angiography
T2 - Result from a large retrospective study
AU - Inamasu, Joji
AU - Nakamura, Yoshiki
AU - Saito, Ryoichi
AU - Horiguchi, Takashi
AU - Kuroshima, Yoshiaki
AU - Mayanagi, Keita
AU - Orii, Maaya
AU - Ichikizaki, Kiyoshi
PY - 2003/12
Y1 - 2003/12
N2 - Not infrequently, cerebral angiography performed immediately after the onset of subarachnoid hemorrhage (SAH) fails to reveal any causative lesion. Although the cause of the SAH in most of these cases remains unknown, repeat angiography sometimes discloses a lesion not detected by the initial angiography. The frequency of finding a ruptured aneurysm by repeat angiography and the angiographic characteristics of such aneurysms have been investigated retrospectively. Nineteen among 316 non-traumatic SAH patients (6%) showed initially negative angiogram, and 7 of 19 patients (36%) were identified as harboring an "initially occult" aneurysm. It was possible to identify the expected cause of these initial false-negative angiograms in four of those seven patients. The aneurysm was located in the anterior communicating artery (ACoA) complex in four of the seven patients. When interpreting the angiograms of patients with SAH, neurologists and neurosurgeons should bear in mind the finding that the ACoA complex is the most frequent site of "initially occult" aneurysms. One patient had a dissecting aneurysm of the internal carotid artery, and although such lesions have been considered rare, they should be included in the differential diagnosis of SAH of unknown origin.
AB - Not infrequently, cerebral angiography performed immediately after the onset of subarachnoid hemorrhage (SAH) fails to reveal any causative lesion. Although the cause of the SAH in most of these cases remains unknown, repeat angiography sometimes discloses a lesion not detected by the initial angiography. The frequency of finding a ruptured aneurysm by repeat angiography and the angiographic characteristics of such aneurysms have been investigated retrospectively. Nineteen among 316 non-traumatic SAH patients (6%) showed initially negative angiogram, and 7 of 19 patients (36%) were identified as harboring an "initially occult" aneurysm. It was possible to identify the expected cause of these initial false-negative angiograms in four of those seven patients. The aneurysm was located in the anterior communicating artery (ACoA) complex in four of the seven patients. When interpreting the angiograms of patients with SAH, neurologists and neurosurgeons should bear in mind the finding that the ACoA complex is the most frequent site of "initially occult" aneurysms. One patient had a dissecting aneurysm of the internal carotid artery, and although such lesions have been considered rare, they should be included in the differential diagnosis of SAH of unknown origin.
KW - Anterior communicating artery
KW - Dissecting aneurysm
KW - Occult
KW - Repeat angiography
KW - Subarachnoid hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=0344982898&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0344982898&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2003.09.002
DO - 10.1016/j.clineuro.2003.09.002
M3 - Article
C2 - 14643914
AN - SCOPUS:0344982898
VL - 106
SP - 33
EP - 37
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
SN - 0303-8467
IS - 1
ER -