Abstract
Neuroimaging is a key element in the management of patients suffering from subarachnoid haemorrhage (SAH). In this article, we review the current literature to provide a summary of the existing neuroimaging methods available in clinical practice. Noncontrast computed tomography is highly sensitive in detecting subarachnoid blood, especially within 6 hours of haemorrhage. However, lumbar puncture should follow a negative noncontrast computed tomography scan in patients with symptoms suspicious of SAH. Computed tomography angiography is slowly replacing digital subtraction angiography as the first-line technique for the diagnosis and treatment planning of cerebral aneurysms, but digital subtraction angiography is still required in patients with diffuse SAH and negative initial computed tomography angiography. Delayed cerebral ischaemia is a common and serious complication after SAH. The modern concept of delayed cerebral ischaemia monitoring is shifting from modalities that measure vessel diameter to techniques focusing on brain perfusion. Lastly, evolving modalities applied to assess cerebral physiological, functional and cognitive sequelae after SAH, such as functional magnetic resonance imaging or positron emission tomography, are discussed. These new techniques may have the advantage over structural modalities due to their ability to assess brain physiology and function in real time. However, their use remains mainly experimental and the literature supporting their practice is still scarce.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-014-0557-2) contains supplementary material, which is available to authorized users.
Highlights
Aneurysmal subarachnoid haemorrhage (SAH) is caused by the rupture of an intracranial aneurysm, which leads to the extravasation of blood under high pressure into the subarachnoid space
The results showed that SAH patients with perfusion changes measured by Computed tomography perfusion (CTP) had 23 times higher odds of having delayed cerebral ischaemia (DCI) than patients with normal CTP parameters
noncontrast computed tomography (NCCT) might be sufficient to rule out SAH if performed within 6 hours of headache onset
Summary
Aneurysmal subarachnoid haemorrhage (SAH) is caused by the rupture of an intracranial aneurysm, which leads to the extravasation of blood under high pressure into the subarachnoid space. Some studies showed that negative CTA can rule out aneurysmal SAH in patients with severe headache and negative NCCT or perimesencephalic haemorrhage pattern [14,15]. Diagnosis of cerebral aneurysms Sensitivity and specificity for the detection of aneurysms >3 mm using CTA currently approach 100%, and are comparable with digital subtraction angiography (DSA) [17,18,19,20].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
