Imaging Evaluation of SAH and Aneurysm

Overview Subarachnoid Hemorrhage (SAH) Ruptured intracranial aneurysm (80% of non-traumatic cases). Vascular malformations (up to 5% of cases). Imaging workup Non-enhanced CT (NECT) of the head (sensitivity 98%) CTA Performed if NECT positive Specificity 100%, sensitivity 96-99.7% for >4mm aneurysms MRI/MRA Uncommonly used for acute SAH For more information, please see the corresponding chapter in Radiopaedia Intracranial Aneurysms Incidence of intracranial aneurysms is 2-3% in the general population Saccular aneurysms Typically arise at arterial branch points Far more common than intracranial arterial dissections and dissecting pseudoaneurysms May be associated with high velocity flow phenomena Feeding vessels to dural AVFs Feeding and intra-nidal AVM vessels Vessels associated with infection, trauma, and neoplasm Cause fewer than 5% of all aneurysms ...

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