التفاصيل البيبلوغرافية
| العنوان: |
Appreciation of CT-negative, lumbar puncture-positive subarachnoid haemorrhage: risk factors for presence of aneurysms and diagnostic yield of imaging. |
| المؤلفون: |
Bakker, Nicolaas A., Groen, Rob J. M., Foumani, Mahrouz, Uyttenboogaart, Maarten, Eshghi, Omid S., Metzemaekers, Jan D. M., Jan Luijckx, Gert, Van Dijk, J. Marc C. |
| المصدر: |
Journal of Neurology, Neurosurgery & Psychiatry; Aug2014, Vol. 85 Issue 8, p883-886, 4p, 2 Charts |
| مصطلحات موضوعية: |
SUBARACHNOID hemorrhage, COMPUTED tomography, ANEURYSMS, DIAGNOSTIC imaging, BRAIN abnormalities, DIAGNOSIS, DISEASE risk factors |
| مستخلص: |
Objective: Patients without a subarachnoid haemorrhage (SAH) on brain CT scan (CT-negative), but a lumbar puncture (LP)-proven SAH, are a challenging patient category. The optimal diagnostic approach is still a matter of debate. Also, there is little knowledge on the probability of finding an underlying vascular lesion. Design: In this observational study, a consecutive cohort of 94 patients with CT-negative, LP-positive SAH was prospectively collected between 1998 and 2013. The yield of diagnostic modalities as well as patient outcome was studied. In addition, risk factors for the presence of a vascular lesion were analysed. Results: In 40 patients (43%), an intracranial vascular abnormality was detected: 37 aneurysms and three arterial dissections. Female gender was significantly associated with detection of a vascular lesion. Time between ictus and diagnosis of SAH was not associated with the presence of vascular pathology. Overall, 99% of patients had a modified Rankin Score of 0 - 2 after a median follow-up of 72 months. The yield of additional digital subtraction angiography in patients with a negative CT angiography was zero. Conclusions: In this study, the chance of finding a vascular lesion in a patient with CT-negative, LP-positive SAH was 43%, underlining the need for an adequate diagnostic workup. In general, the patient outcome was favourable. Female gender was found to be predictive for detecting a vascular lesion. In contrast with previous reports, the interval between ictus and LP was not associated with the presence of an aneurysm. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
