Value of delayed MRI in angiogram-negative subarachnoid haemorrhage

J Woodfield, N Rane, S Cudlip, J V Byrne

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Aim: To assess the efficacy of delayed magnetic resonance imaging (MRI) in identifying a structural cause for angiogram-negative subarachnoid haemorrhage.

Materials and Methods: All patients presenting with spontaneous subarachnoid haemorrhage who had negative computed tomography (CT) angiography and catheter angiography between 2006 and 2012 were reviewed.

Results: During the 6 year period, 1023 angiograms were performed for a new presentation of subarachnoid haemorrhage. Of these, 242 (23.7%) did not show a cause for the haemorrhage. A second catheter angiogram was performed in 48 patients, and aneurysms were identified in two patients. Of the remaining 240 patients, 131 underwent a subsequent MRI brain. One hundred and five (80.2%) MRI examinations were performed 4 or more weeks after angiography. In two patients, cavernomas were identified as the likely bleeding source. In both patients, the pattern of subarachnoid haemorrhage surrounding a small intraparenchymal haemorrhage on the initial CT suggested the diagnosis. Thirty-nine patients underwent MRI of the cervical spine, none of which identified a cause for the haemorrhage. None of the patients re-presented to our centre during the 6 year study period.

Conclusion: Delayed MRI following angiogram-negative subarachnoid haemorrhage has a low (1.5%) yield and is not routinely necessary. MRI may be useful to characterize the diagnosis in patients with clinical or radiological features of an underlying abnormality such as a cavernoma.

Original languageEnglish
Pages (from-to)350-356
Number of pages7
JournalClinical Radiology
Volume69
Issue number4
Early online date20 Dec 2013
DOIs
Publication statusPublished - 1 Apr 2014

Keywords / Materials (for Non-textual outputs)

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction
  • Brain
  • Cerebral Angiography
  • Female
  • Follow-Up Studies
  • Great Britain
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spine
  • Subarachnoid Hemorrhage
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

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