Relationship between contrast enhancement on computed tomography and cerebral vasospasm in patients with subarachnoid hemorrhage.
To elucidate the relationship between abnormal enhancement of the cisterns on computed tomography and cerebral vasospasm, we performed a systematic and prospective study in 60 patients with ruptured cerebral aneurysms. There is a significant relationship between the findings of contrast-enhanced computed tomography (CECT) within Day 3 of rupture and cerebral vasospasm. Among 37 patients undergoing CECT between Day 0 and Day 3, 17 (46%) showed prominent increases in density in the region around the circle of Willis and its branches. In 13 of 17 cases (76%), severe vasospasm with motor paralysis occurred. In the remaining 4 cases (24%) with only slight or no cerebral vasospasm, the hematoma in the subarachnoid space was removed surgically by Day 3. In 19 of 20 cases without remarkable CECT, no severe cerebral vasospasm with motor paralysis occurred. There is no significant relationship between the CECT findings after Day 3 and cerebral vasospasm. The results indicate that the prominent increase in density in the region of the circle of Willis and its branches often observed on CECT within Day 3 of subarachnoid hemorrhage is useful for prediction of the occurrence of cerebral vasospasm and also provide information on the pathogenesis of cerebral vasospasm.
D000368:Aged; D002941:Circle of Willis; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications; D007482:Iothalamate Meglumine; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D007482:Iothalamate Meglumine