Cumulative radiation dose during hospitalization for aneurysmal subarachnoid hemorrhage.
OBJECTIVE
Radiation exposure from neurointerventional procedures and diagnostic neuroimaging can be substantial, with many recommendations offered to guide the interventionalist in the conscientious use of ionizing radiation. Patients presenting with an aneurysmal subarachnoid hemorrhage can undergo multiple imaging procedures during a prolonged hospital course. Therefore, we reviewed a cohort of such patients to identify the sources and quantify the cumulative radiation exposure seen during their hospitalization.


METHODS
We retrospectively reviewed a single-center experience with these patients to define the potential for short-term skin injury and long-term oncologic risk due to absorbed radiation dose and sources of ionizing radiation and their contribution to the cumulative absorbed dose to the cranial tissues.


RESULTS
We demonstrated that substantial cumulative doses can be seen, with 87% of the cumulative absorbed dose occurring during neurointerventional procedures and 7% from CT. Mathematic modeling was performed identifying potential techniques to further reduce the cumulative radiation absorbed dose to these patients.


CONCLUSIONS
We conclude that repetitive irradiation during the care of patients with aneurysmal subarachnoid hemorrhage can result in significant cumulative doses and a variety of techniques can be applied to reduce this absorbed dose. Use of radiation for diagnostic and therapeutic purposes during prolonged procedures of patients with subarachnoid hemorrhage demands diligence throughout the hospitalization.
Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. moskows@ccf.org
S I
SI
Moskowitz
W J
WJ
Davros
M E
ME
Kelly
D
D
Fiorella
P A
PA
Rasmussen
T J
TJ
Masaryk
D002533:Cerebral Angiography / Q000009:adverse effects* / Q000706:statistics & numerical data; D005471:Fluoroscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012871:Skin Diseases / Q000453:epidemiology / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000706:statistics & numerical data