Evaluation DSA-angiography in patients with SAH and normal CT-angiography

Abstract

Subarachnoid hemorrhages are life-threatening and result from the accumulation of blood between the arachnoid and pia mater. The incidence of subarachnoid hemorrhage in the United States is between 10 to 14 out of 100,000 individuals per year. Most of the aneurysmal ruptures occur in patients older than 50 years old. While a severe headache during strenuous postcoital activity is a typical scenario, 30% of subarachnoid hemorrhage occurs during sleep. Occasionally subarachnoid aneurysmal hemorrhage is preceded by warning sharp, severe headache, or a sentinel headache, that happens a few weeks before the rupture. The study aimed to evaluate DSA-angiography in patients with SAH. Method In this cross-sectional study, the studied patients were admitted to the study by considering the inclusion and exclusion criteria. At baseline, CT-scan was performed for patients without cerebral contrast. According to the CT-Scan result, patients were divided into four groups according to the subarachnoid hemorrhage pattern without contrast. Patients then underwent CTA with 64 incisions and DSA. Patients were selected for DSA regardless of CTA results. Negative and normal CTA results were selected and then compared with DSA results. The sensitivity and specificity of CTA to DSA (Gold Standard Method) were measured. Results Mean ± Standard Deviation of patients ages was 54.2 ± 12.48. In the DSA performed between the subjects, aneurysm was observed in 31 patients (56.4%) and in DSA in 24 patients (43.6%) no aneurysm was observed. No false positives were seen in the CTA report among the patients studied. Also, among the normal CTA reports in 6 patients (20%), the CTA report was false negative. According to CTA reports in the studied patients, the sensitivity of CTA was 80.64% and its specificity was 100%.