Clinical condition—Cerebrovascular disease: Hemorrhage
| MRI, brain, with or without contrast | CT, head, without contrast | CT, head, without and with contrast | MRA, head, with or without contrast | MRA, neck, with or without contrast | CTA, neck | CTA, head | Arterio-graphy, head and neck | Arterio-graphy, neck | US, trans cranial, Doppler | |
|---|---|---|---|---|---|---|---|---|---|---|
| Aneurysm: Risk for unruptured aneurysm. Positive family history | 6 | 3 | 3 | 8b | 3 | 2 | 8bc | 1 | 1 | 1 |
| SAH: clinically suspected subarachnoid hemorrhage, not yet confirmed | 4 | 9 | 5 | 4 | 2 | 2d | 2 | 2 | 2 | 1 |
| SAH: proven by lumbar puncture or imaging | 6 | 8 | 5 | 7 | 6d | 6d | 8 | 8 | 8de | 5f |
| SAH: proven but negative angiogram, follow-up | 8ab | 5 | 4 | 8ab | 5 | 5 | 8b | 8 | 5 | 5f |
| Hematoma: clinically suspected parenchymal hemorrhage, not yet confirmed | 7 | 8 | 7 | 4 | 3 | 3 | 4 | 3 | 2 | 1 |
| Hematoma: proven parenchymal hemorrhage | 8ab | 8ab | 7 | 8ab | 5 | 5 | 8ab | 7g | 7 | 1 |
Note:—Appropriateness criteria scale from 1 to 9, 1 = least appropriate, 9 = most appropriate;
a , combined vascular and cerebral evaluation;
b , MR preferred if treatment not unreasonably delayed should be considered;
c , noncontrast CT obtained routinely at the same time;
d , for treatment planning;
e , as part of cerebral angiography;
f , for vasospasm;
g , if suspect AVM