title: Repeated neurovascular imaging in subarachnoid hemorrhage when initial studies are negative.
abstract: Approximately 15% of patients with non-traumatic subarachnoid hemorrhage have no causative lesion identified on their initial angiogram. We present two patients with non-traumatic subarachnoid hemorrhage with negative initial angiograms who were subsequently found to have small basilar perforator aneurysms on delayed neurovascular imaging. We discuss the possible mechanisms for false negative diagnostic cerebral angiograms. These patients support the current standard of care with repeat angiography in cases of subarachnoid hemorrhage when no causative lesion can be identified on initial neurovascular imaging.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Grannan
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Yanamadala
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA. Electronic address: walcott.brian@mgh.harvard.edu.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Walcott
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Stapleton
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ogilvy
mesh_terms: D000368:Aged; D002533:Cerebral Angiography / Q000592:standards*; D003952:Diagnostic Imaging / Q000592:standards; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging*
keywords: Angiography; Cerebral angiography; Intracranial aneurysm; Subarachnoid hemorrhage