Title: CT Angiography detection of ruptured intracranial aneurysms with subarachnoid hemorrhage in a hospital-based population
Authors: Dr Sumana Bingi, Dr Venkatesh Basina, Dr N Giridhar Gopal
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.11
Abstract
Background: Rupture of an intracranial aneurysm presents as subarachnoid hemorrhage (SAH). SAH is a catastrophic event with an overall mortality rate varying from 32-37%. It may be commonly be associated with intraparenchymal hemorrhage (IPH), intraventricular hemorrhage (IVH), subdural hemorrhage (SDH).
Objectives: To know the frequency, most common site of aneurysms and associated anatomical variants in patients with ruptured intracranial aneurysms.
Material and Methods: The study includes 150 patients who have undergone CT Angiography at with symptoms like headache, neck stiffness, and clinically diagnosed SAH. The required data were collected on a retrospective basis from the database available at Great eastern medical school and hospital from January 2017 to March 2019. From the obtained data, the prevalence, common site of intracranial aneurysms and anatomical variants (if any) were evaluated.
Results: A total of 150 patients have undergone non-contrast CT and further angiographic imaging at Great eastern medical school and hospital from January 2017 to March 2019, of which 20 patients were documented with ruptured intracranial aneurysms. Of these patients, the mean age was 51 years with equal incidence in males and females. 65% of the aneurysms were seen on the left and 35% on the right side. 84% of the aneurysms were in the anterior circulation and 16% in the posterior circulation. Isolated aneurysms were seen in 70% and synchronous aneurysms in 30% of the study population. The most common site of aneurysms was in the supraclinoid ICA corresponding to 34.6%. The other sites were 30.7% in MCA, 11.5 % in Acom,11.5% in PCA, 3.8% in Pcom, 3.8% in ACA and 3.8% in Vertebral arteries respectively. Anatomical variants were seen with 25% of the study population, predominantly in the posterior circulation.
Conclusion: Any CT scan showing an intraparenchymal hemorrhage in the temporal lobe, with or without a frontal, parietal and intraventricular extension should be looked in for any ruptured aneurysms even in the absence of SAH.
Keywords: Subarachnoid hemorrhage, Aneurysm, CT Angiography.
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