Subarachnoid hemorrhage other diagnostic studies

Subarachnoid Hemorrhage Microchapters

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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Sara Mehrsefat, M.D. [2]

## Overview

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Other diagnostic studies for subarachnoid hemorrhage include spinal angiography and surgical exploration. [1][2]

## Other diagnostic studies

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### Surgical exploration

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Surgical exploration is not a routine diagnostic evaluation. However, It is the best diagnostic aspect in diagnosis of ruptured aneurysm and it has a diagnostic value even after two or more negative angiograms.[1][3]

### Spinal angiography

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Spinal angiography also should be considered in patient with SAH especially after:[2][4]

* A clinical suspicion for a spinal vascular anomaly (prominent back/neck pain and radicular on examination)
* Presence of abnormal finding on other neuroimaging studies

## References

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1. ↑ 1.0 1.1 Tatter SB, Crowell RM, Ogilvy CS (1995). "Aneurysmal and microaneurysmal "angiogram-negative" subarachnoid hemorrhage". Neurosurgery. 37 (1): 48–55. PMID 8587690.CS1 maint: Multiple names: authors list (link)
2. ↑ 2.0 2.1 Kinouchi H, Mizoi K, Takahashi A, Nagamine Y, Koshu K, Yoshimoto T (1998). "Dural arteriovenous shunts at the craniocervical junction". J Neurosurg. 89 (5): 755–61. doi:10.3171/jns.1998.89.5.0755. PMID 9817413.CS1 maint: Multiple names: authors list (link)
3. ↑ Di Lorenzo N, Guidetti G (1988). "Anterior communicating aneurysm missed at angiography: report of two cases treated surgically". Neurosurgery. 23 (4): 494–9. PMID 3200381.
4. ↑ van Beijnum J, Straver DC, Rinkel GJ, Klijn CJ (2007). "Spinal arteriovenous shunts presenting as intracranial subarachnoid haemorrhage". J Neurol. 254 (8): 1044–51. doi:10.1007/s00415-006-0485-4. PMC 2779417. PMID 17401739.CS1 maint: Multiple names: authors list (link)

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