Subarachnoid hemorrhage of unknown etiology. Operative findings of unclear aneurysms in initial angiography.:Operative findings of unclear aneurysms in initial angiography
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We studied 20 patients with subarachnoid hemorrhage of unknown etiology who admitted to our clinic during the last 10 years from 1980 to 1989. Aneurysms were detected in 14 patients by either repeat angiography or exploratory surgery. The most frequent causes of unvisualized aneurysms on the initial angiography were small in size and/or protrusion at the wall unrelated to the arterial division. Most cases with diffuse subarachnoid clots or localized Sylvian clots on CT had their aneurysms revealed by repeat angiography and/or exploratory surgery. None of cases with localized perimesencephalic clots on CT had aneurysms detected by angiography and/or exploratory surgery. Repeat angiography revealed aneurysms in 54% (7/13) of the cases. The timing of repeat angiographies was plotted with respect to positive and negative visualization : the average times were 12 days in patients without visualization, and 22 days in patients with visualization. Seven patients had early exploratory surgery without repeat angiographies, five of them were detected ruptured aneurysms by the surgeries.<BR>At least, we believe, angiography should be reexamined at about three weeks after the onset. Sometimes, exploratory surgery is indicated in the case with probable ruptured aneurysm even in early stage.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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