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Active Bleeding in Acute Subarachnoid Hemorrhage Observed by Multiphase Dynamic-Enhanced CT

Active Bleeding in Acute Subarachnoid Hemorrhage Observed by Multiphase Dynamic-Enhanced CT BACKGROUND AND PURPOSE: Acute SAH is reportedly associated with rebleeding from aneurysms, and recent advances in imaging technology allow us to visualize active bleeding in SAH cases. This study aimed to retrospectively investigate the incidence and characteristics of active bleeding in patients with spontaneous SAH by using multiphase dynamic-enhanced CT. MATERIALS AND METHODS: We retrospectively surveyed a series of patients with SAH who underwent CTP with 18-phase dynamic enhancement and confirmed the presence of extravasated contrast medium in the source image. We compared clinical features between 2 groups of patients with and without extravasation. RESULTS: Active bleeding was observed with increasing enhancement in 25.5% (13/51) of patients. All patients with extravasation were in Claassen grade 3 or 4 and WFNS grades 3, 4, or 5. The other group without extravasation included patients in all grades. A significant difference was observed in Claassen grade, WFNS grade, and increase of hematomas in follow-up CT ( P < .05, for each) between the 2 groups. All CTP results of patients with extravasation were obtained within 2 hours of the onset of symptoms of SAH ( P < .05). There was no significant difference in mortality at 14 days between the 2 groups ( P = .128). CONCLUSIONS: A high incidence of active bleeding (25.5%) was detected by multiphase dynamic-enhanced CT in patients with acute SAH. These results indicate that an awareness of active bleeding in patients with SAH has the potential to affect the treatment strategy. ABBREVIATIONS: ACA anterior cerebral artery BA basilar artery ICH intracerebral hemorrhage VA vertebral artery WFNS World Federation of Neurosurgical Societies http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Active Bleeding in Acute Subarachnoid Hemorrhage Observed by Multiphase Dynamic-Enhanced CT

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2012 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2981
pmid
22383241
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Acute SAH is reportedly associated with rebleeding from aneurysms, and recent advances in imaging technology allow us to visualize active bleeding in SAH cases. This study aimed to retrospectively investigate the incidence and characteristics of active bleeding in patients with spontaneous SAH by using multiphase dynamic-enhanced CT. MATERIALS AND METHODS: We retrospectively surveyed a series of patients with SAH who underwent CTP with 18-phase dynamic enhancement and confirmed the presence of extravasated contrast medium in the source image. We compared clinical features between 2 groups of patients with and without extravasation. RESULTS: Active bleeding was observed with increasing enhancement in 25.5% (13/51) of patients. All patients with extravasation were in Claassen grade 3 or 4 and WFNS grades 3, 4, or 5. The other group without extravasation included patients in all grades. A significant difference was observed in Claassen grade, WFNS grade, and increase of hematomas in follow-up CT ( P < .05, for each) between the 2 groups. All CTP results of patients with extravasation were obtained within 2 hours of the onset of symptoms of SAH ( P < .05). There was no significant difference in mortality at 14 days between the 2 groups ( P = .128). CONCLUSIONS: A high incidence of active bleeding (25.5%) was detected by multiphase dynamic-enhanced CT in patients with acute SAH. These results indicate that an awareness of active bleeding in patients with SAH has the potential to affect the treatment strategy. ABBREVIATIONS: ACA anterior cerebral artery BA basilar artery ICH intracerebral hemorrhage VA vertebral artery WFNS World Federation of Neurosurgical Societies

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Aug 1, 2012

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