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Subarachnoid Hemorrhage and Normal Angiography: Should the Angiogram be Reviewed by a Second Neuroradiologist?

Published online by Cambridge University Press:  18 September 2015

Ashfaq Shuaib ,
Mary Anne Lee ,
Robert D. Johns  and
Harold A. Swanson
Ashfaq Shuaib
Affiliation:
Department of Clinical Neurosciences, Foothills Hospital, Calgary
Mary Anne Lee*
Affiliation:
Department of Clinical Neurosciences, Foothills Hospital, Calgary
Robert D. Johns
Affiliation:
Department of Clinical Neurosciences, Foothills Hospital, Calgary
Harold A. Swanson
Affiliation:
Department of Clinical Neurosciences, Foothills Hospital, Calgary
*
Department of Clinical Neurosciences, Foothills Hospital, Calgary, Alberta, Canada T2N 2T9
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Abstract:

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In recent years there has been a tendency to abandon repeat cerebral angiography in patients with subarachnoid hemorrhage (SAH) if the initial angiogram is normal because prognosis is said to be excellent. Our experience does not support such a conclusion. We report our experiences in 25 patients with SAH, who had a normal initial angiogram. Aneurysms were seen in five of 20 cases when angiography was repeated. On subsequent review of the initial angiograms, the aneurysm was apparent in four of the five cases. When these four initial angiograms were shown to a second observer, unaware of the results of the second study, three of the four aneurysms were correctly identified. We suggest that if, under strong clinical suspicion of SAH, the angiogram is reported as normal the study should be reviewed by a second neuro-radiologist before proceeding to repeat angiography.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 15 , Issue 4 , November 1988 , pp. 413 - 416
Copyright
Copyright © Canadian Neurological Sciences Federation 1988

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