Usefulness of computed cerebral angiotomography for direct detection of intracranial aneurysms

S. Asari, M. Sakurai, Yuji Yamamoto, K. Sadamoto

Research output: Contribution to journalArticle

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Abstract

Usefulness of computed cerebral angiotomography for direct detection of intracranial aneurysms was studied. Among 41 aneurysms in the series, 31 (80.5%) were detected by computed cerebral angiotomography. Detection rates of aneurysms depended on the size, i.e., 56.3% in 16 aneurysms smaller than 5 mm in diameter, 94.7% in 19 between 6 and 10 mm, and 100% in six aneurysms larger than 10 mm. The smallest aneurysm detected by computed cerebral angiotomography was 5x4x4 mm in size on the angiogram. Location of the aneurysms affected the detection rate as follows: 88.2% in 17 anterior cerebral artery aneurysms (16 anterior communicating artery aneurysms and one A1 portion), 77.8% in 9 middle cerebral artery aneurysms, 87.5% in 8 aneurysms of the supraclinoid portion of the internal carotid artery (ICA), 0% in 2 internal carotid-ophthalmic artery aneurysms, 75% in 4 aneurysms of the upper half of the basilar artery, and 100% in 1 posterior cerebral artery aneurysm. It seems difficult to detect aneurysms in the infraclinoid portion of ICA. Of 24 patients with subarachnoid hemorrhage, ruptured aneurysms were detected in 22 by computed cerebral angiotomography. Initial CT findings in 64% of these 22 patients showed no evidence of blood or diffuse or symmetrical high-density areas in the subarachnoid space. In these patients, computed cerebral angiotomography was useful for topographical diagnosis of the ruptured aneurysm. Incidental asymptomatic aneurysms were detected in 9 out of 33 patients in this series. An aneurysm may be suggested by a round or oval isodensity defect in the Sylvian fissure or suprasellar cistern, defect of the edge of the so-called 'pentagon' in plain CT, and then if its density is highly and homogeneously increased and continuous, with the main cerebral arteries on computed cerebral angiotomogram. Computed cerebral angiotomography raised the detection rate of intracranial aneurysms. It was possible to recognize not only aneurysms themselves but also afferent and efferent arteries continuous with aneurysms, the relation between the aneurysm and cistern, parenchymal brain-tissue and hematoma surrounding the aneurysm by computed cerebral angiotomography. Nine cases of incidental asymptomatic aneurysms were detected directly by computed cerebral angiotomography. This non-invasive method seems to be useful as a screening procedure to discover non-ruptured asymptomatic aneurysms. There is a possibility that location of an aneurysm can be shown by computed cerebral angiotomography before invasive angiography.

Original languageEnglish
Pages (from-to)1095-1104
Number of pages10
JournalNeurologia Medico-Chirurgica
Volume21
Issue number11
Publication statusPublished - 1981
Externally publishedYes

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Intracranial Aneurysm
Aneurysm
Internal Carotid Artery
Ruptured Aneurysm
Angiography
Ophthalmic Artery
Subarachnoid Space
Basilar Artery
Cerebral Arteries
Subarachnoid Hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Usefulness of computed cerebral angiotomography for direct detection of intracranial aneurysms. / Asari, S.; Sakurai, M.; Yamamoto, Yuji; Sadamoto, K.

In: Neurologia Medico-Chirurgica, Vol. 21, No. 11, 1981, p. 1095-1104.

Research output: Contribution to journalArticle

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abstract = "Usefulness of computed cerebral angiotomography for direct detection of intracranial aneurysms was studied. Among 41 aneurysms in the series, 31 (80.5{\%}) were detected by computed cerebral angiotomography. Detection rates of aneurysms depended on the size, i.e., 56.3{\%} in 16 aneurysms smaller than 5 mm in diameter, 94.7{\%} in 19 between 6 and 10 mm, and 100{\%} in six aneurysms larger than 10 mm. The smallest aneurysm detected by computed cerebral angiotomography was 5x4x4 mm in size on the angiogram. Location of the aneurysms affected the detection rate as follows: 88.2{\%} in 17 anterior cerebral artery aneurysms (16 anterior communicating artery aneurysms and one A1 portion), 77.8{\%} in 9 middle cerebral artery aneurysms, 87.5{\%} in 8 aneurysms of the supraclinoid portion of the internal carotid artery (ICA), 0{\%} in 2 internal carotid-ophthalmic artery aneurysms, 75{\%} in 4 aneurysms of the upper half of the basilar artery, and 100{\%} in 1 posterior cerebral artery aneurysm. It seems difficult to detect aneurysms in the infraclinoid portion of ICA. Of 24 patients with subarachnoid hemorrhage, ruptured aneurysms were detected in 22 by computed cerebral angiotomography. Initial CT findings in 64{\%} of these 22 patients showed no evidence of blood or diffuse or symmetrical high-density areas in the subarachnoid space. In these patients, computed cerebral angiotomography was useful for topographical diagnosis of the ruptured aneurysm. Incidental asymptomatic aneurysms were detected in 9 out of 33 patients in this series. An aneurysm may be suggested by a round or oval isodensity defect in the Sylvian fissure or suprasellar cistern, defect of the edge of the so-called 'pentagon' in plain CT, and then if its density is highly and homogeneously increased and continuous, with the main cerebral arteries on computed cerebral angiotomogram. Computed cerebral angiotomography raised the detection rate of intracranial aneurysms. It was possible to recognize not only aneurysms themselves but also afferent and efferent arteries continuous with aneurysms, the relation between the aneurysm and cistern, parenchymal brain-tissue and hematoma surrounding the aneurysm by computed cerebral angiotomography. Nine cases of incidental asymptomatic aneurysms were detected directly by computed cerebral angiotomography. This non-invasive method seems to be useful as a screening procedure to discover non-ruptured asymptomatic aneurysms. There is a possibility that location of an aneurysm can be shown by computed cerebral angiotomography before invasive angiography.",
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