This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: We studied the diagnostic power of blood distribution on CT (performed within 72 hours after the bleed) for the site of ruptured aneurysm in 168 consecutive patients with subarachnoid hemorrhage with either a single aneurysm or no aneurysm on the four-vessel angiogram or postmortem examination.
Methods: A neurosurgeon and a neuroradiologist blind to the results of the angiography independently scored the distribution of blood on the CT and predicted the site of the ruptured aneurysm.
Results: Overall agreement among raters was 52% and chance-adjusted agreement (kappa) was 0.42 (weighted kappa value 0.47). A parenchymal cerebral hematoma was an excellent predictor for the site of a ruptured aneurysm but was present in only a minority of cases (15%). The next most valid predictor was blood distribution on CT in patients with a ruptured anterior cerebral artery aneurysm or anterior communicating artery aneurysm (sensitivity 0.79, specificity 0.96, and positive predictive value 0.79 for rater 1; sensitivity 0.77, specificity 0.97, and positive predictive value 0.90 for rater 2). The validity of the predictive value of blood distribution on CT in patients with a ruptured aneurysm of the middle cerebral artery, internal carotid artery, or posterior circulation arteries was either inconsistent between raters or low.
Conclusion: With the exception of the presence of a parenchymal hematoma, the site of the ruptured aneurysm can be predicted by CT only in ruptured anterior cerebral artery or anterior communicating artery aneurysms.
- Received May 20, 1998.
- Accepted September 12, 1998.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hastening the Diagnosis of Amyotrophic Lateral Sclerosis
Dr. Brian Callaghan and Dr. Kellen Quigg