Reangiografie nach initial negativer invasiver und nicht-invasiver Bildgebung bei Patienten mit atraumatischer SAB

Abstract

Ziele: This study aimed to determine the yield of DSA for the detection of causative vascular lesions in patients with atraumatic SAH and negative initial noninvasive and invasive neurovascular examinations (CTA, DSA and MRA). Methode: We examined the yield of repetitive DSA for the detection of causative vascular lesions in 750 patients presenting to our institution with SAH and 90 of them with subarachnoidal blood and negative initial noninvasive and invasive neurovascular examinations during a 10-year period. Ergebnis: Repetitive DSA demonstrated a causative vascular lesion in 4 patients (4.5%; 4/90) in all other patients no causative vascular lesion was found Schlussfolgerung: Repetitive DSA shows a bleeding source after initially negative imaging diagnostics in some cases. But as these findings have a therapeutic and prognostic impact, we think that a repetitive DSA can be recommended in patients with SAH, even under consideration of the risk of a second invasive diagnostic angiography itself.