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Subarachnoid Hemorrhage Without Detectable Aneurysm
Stroke 24:1403-1409, Rinkel,G.J.E.,et al, 1993
See this aricle in Pubmed

Article Abstract
Patients in whom no aneurysm is revealed on the initial angiogram can be subdivided mainly according to the pattern of hemorrhage on an early CT scan.In two thirds of these patients the CT scan shows a perimesencephalic pattern of hemorrhage(ie,blood confined to the cisterns around the midbrain);these patients invariably have a good prognosis,which obviates the need for a second angiogram.Patients with diffuse or anteriorly located blood on CT scan are at risk of rebleeding.In most of these patients the source of hemorrhage is an occult aneurysm,but intracranial artery dissections,dural arteriovenous malformations,mycotic aneurysms, trauma,bleeding disorders,substance abuse,or a cervical origin of the hemorrhage should also be considered.Patients with no blood revealed on an early CT scan but with xanthochromic cerebrospinal fluid are extremely rare.These patients deserve a second reading of the scan for blood in the prepontine cistern,which can be the only site of hemorrhage in perimesencephalic hemorrhage.The prognosis and management of patients in whom no aneurysm is found on the initial angiogram depends on the pattern of hemorrhage on the initial CT scan.Patients should no longer be designated with the umbrella term"angiogram-negative subarachnoid hemorrhage."
 
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angiography,cerebral
angiography,cerebral,indications
CAT scan
CAT scan,abnormal
head injury
precipitating factors
prognosis
review article
subarachnoid hemorrhage
subarachnoid hemorrhage,causes of
subarachnoid hemorrhage,normal cerebral angiography with
subarachnoid hemorrhage,perimesencephalic
subarachnoid hemorrhage,prognosis
trauma

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