Subarachnoid hemorrhage: aneurysm detection and preoperative evaluation with CT angiography: Aneurysm detection and preoperative evaluation with CT angiography

B. K. Velthuis, G. J. Rinkel, L. M. Ramos, T. D. Witkamp, J. W. Berkelbach van der Sprenkel, W. P. Vandertop, M. S. van Leeuwen

Research output: Contribution to journalArticleAcademicpeer-review

165 Citations (Scopus)


To evaluate if computed tomographic (CT) angiography can replace digital subtraction angiography (DSA) for aneurysm detection and as preoperative work-up in patients with subarachnoid hemorrhage (SAH). Prospectively, 100 patients with SAH underwent CT angiography; 80 also underwent DSA. Two observers independently evaluated CT angiographic source images and maximum intensity projection slabs. Neurosurgeons compared CT angiograms and DSA images for presurgical evaluation. On CT angiograms, the observers detected 73 and 70 of 75 symptomatic aneurysms; 96% of the detected aneurysms were classified as definitely present. Of 16 incidental aneurysms, 12 and 10 were detected by the observers. With adequate CT angiographic quality, parent artery side of anterior communicating aneurysms was correctly predicted in 100% (95% confidence interval [CI]: 87%, 100%). Neurosurgeons assessed CT angiography as equal or superior to DSA in 83% (95% CI: 73%, 90%) of 87 aneurysms, and in 74% (95% CI: 63%, 82%) operation might have been based on CT angiographic findings alone. CT angiography depicted 90% of all aneurysms, and 90% were classified as definitely present. CT angiography must be of high quality with adequate depiction of the aneurysm and the parent artery for surgery to be performed on the basis of CT angiographic findings alone
Original languageEnglish
Pages (from-to)423-430
Number of pages8
Issue number2
Publication statusPublished - 1 Jan 1998


  • Aneurysm, intracranial
  • Aneurysm, rupture
  • Computed tomography (CT), angiography
  • Computed tomography (CT), clinical effectiveness
  • Computed tomography (CT), comparative studies
  • Digital subtraction angiography, comparative studies

Cite this