2022年7月4日 · CT angiography (CTA) is highly sensitive and specific (~95%) for aneurysm detection, but may miss very small aneurysms. CTA has numerous potential roles: (1) For patients who have a SAH, CTA is essential to evaluate for underlying vascular anomalies (e.g., aneurysms, arteriovenous malformations).

Computed tomography angiography (CTA) of the brain is a reasonable test to consider when evaluating select patients for subarachnoid hemorrhage after a negative non-contrast computed tomography of the brain. The benefits and risks of CTA of the brain need to be considered by the treating physician.

If unable to obtain CSF consider CTA CTA also highly sensitive for predicting delayed cerebral ischemia; If traumatic tap is suspected Tube 4 RBC count <500 has negative predictive value of 100% for SAH. Tube 4 RBC decrease of 70% compared to tube 1 excludes a radiographically detectable SAH.

Over the last decade, CTA of the brain has become part of the discussion in ruling out SAH. As a non-invasive means of highlighting vascular anatomy and detecting aneurysms, CTA has many advantages. Much like non-contrast head CT, advances in neuroimaging have shown CTA to have a sensitivity of up to 98% and a specificity of 100% for aneurysms ...

2020年1月22日 · Digital subtraction catheter angiography (DSA) with 3 dimension reconstructions is the gold standard diagnostic tool for detecting aneurysms (Figure I in the Data Supplement). 15 A CTA can obviate DSA because it excludes an aneurysm when there is a CT pattern of perimesencephalic SAH and in cases of CT negative, lumbar puncture positive SAH. 16 ...

2020年12月1日 · CTA and MRA can both equally detect aneurysms ~3-5 mm or larger. New, multidetector CTA has improved to >97% sensitive/specific for SAH. In many institutions CTA has been seen as a reasonable alternative to LP (the main drawbacks of CTA are cost and radiation).

2024年5月13日 · LP will help you identify infectious causes of headache like meningitis and non-aneurysmal causes of atraumatic SAH, while CTA will help you identify vascular causes of headache aside from SAH.

CTA in SAH is of great value in demonstrating vascular anatomy and the exact size of an aneurysm. However, IA-DSA is still needed for diagnostic evaluation in aneurysms smaller than 5 mm in diameter, especially in those located near bony structures.

The American Heart Association/American Stroke Association states a CTA could be considered in the workup for suspected aneurysmal SAH (class IIb, level C recommendation) . A CTA is beneficial because it can diagnose other causes of acute headache such as venous thrombosis, stroke, or arteriovenous malformation [ 23 ].

2023年7月3日 · CT reveals subarachnoid hemorrhage (SAH) with midline shift. What is the typical presentation of SAH in the ED? What are the next steps in the management of this patient? What other examination findings are expected? What additional workup is necessary in the ED? SAH has the potential for rapid progression and devastating outcomes.