Summary
Background
Angiography is usually recomended in perimesencephalic subarachnoid haemorrhage (PM SAH) to rule out a basilar artery aneurysm. However it is not known how often aneurysms are found among patients with a CT pattern of PM haemorrhage or the frequency of this CT pattern after rupture of posterior circulation aneurysms.
Method
CTs of all SAH caused by posterior circulation aneurysms admited from 1/85 to 12/92 where reviewed by two examiners. Late (>72 h) examinations were excluded. The remaining CTs were classified in perimesencephalic (PM) or non PM.
Results
81 posterior circulation aneurysms were collected. Only one PM-like CT pattern was found, due to ruptured posterior communicating artery aneurysm (1.3%; 95% Cl (confidence intervals)=.03–6.7%). During the same period 37 PM SAH with negative angiographic results were admited. The likehood of finding an aneurysm in a patient with an early CT showing a PM distribution of haematic densities was 2.7% (95% Cl=.07–14%).
Conclusion
Although the probability of finding an aneurysm in a SAH patient with a PM CT pattern is low, a complete 4-vessel angiogram must be obtained.
Similar content being viewed by others
References
Van Gijn J, Van Dongen KJ, Vermeuler M, Hijdra A (1985) Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology 35: 993–997
Kayama T, Sugawara T, Sakurai K, Ogawa A, Onuma T, Koshimoto T (1991) Early CT features of ruptured cerebral aneurysms of the posterior cranial fossa. Acta Neurochir (Wien) 108: 34–39
Rinkel GJE, Wijdicks FM, Vermeulen M, Ramos MP, Tanghe HI, Hansan D, Meiners L, Van Gijn J (1991) Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. JNR 12: 829–834
Rinkel GJE (1991) Perimesencephalic nonaneurysmal hemorrhage. Thesis Publishers, Amsterdam, p 35
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pinto, A.N., Ferro, J.M., Canhão, P. et al. How often is a perimesencephalic subarachnoid haemorrhage CT pattern caused by ruptured aneurysms?. Acta neurochir 124, 79–81 (1993). https://doi.org/10.1007/BF01401126
Issue Date:
DOI: https://doi.org/10.1007/BF01401126