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Journal of Neurosurgical Sciences 2002 March;46(1):4-9

Copyright © 2002 EDIZIONI MINERVA MEDICA

lingua: Inglese

Use of spiral computerized tomography angiography in patients with cerebral aneurysm. Our experience

Caruso R. 1, Colonnese C. 2, Elefante A. 2, Innocenzi G. 1, Raguso M. 1, Gagliardi F. M. 1

1 Department of Neurosurgery, IRCCS Neuromed, Molise; 2 Department of Neuroradiology, IRCCS Neuromed, Molise


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Background. The pur­pose is to high­light the use­ful­ness of CT angio­gra­phy (CTA) in the diag­no­sis and sur­gi­cal treat­ment of cere­bral aneu­rysms.
Methods. Thirty-one ­patients ­with sub­arach­noid hae­mor­rhag­es ­were sub­ject­ed to CT angio­gra­phy and in ­those cas­es ­where ­this ­test did not ­reveal the aneu­rysm or did not sup­ply suf­fi­cient infor­ma­tion relat­ing to it, sub­se­quent­ly a dig­i­tal sub­trac­tion angio­gra­phy was ­also per­formed. Each aneu­rysm-pos­i­tive CTA was re-pro­cessed ­using the ­3-D tech­niques, ­with the neu­ro-radiol­o­gist and the neu­ro-sur­geon work­ing in ­close co-oper­a­tion.
Results. In 27 cas­es the CTA diag­nosed an aneu­rysm, and in the 4 cas­es ­where no vas­cu­lar mal­for­ma­tions ­were ­revealed, ­also the tra­di­tion­al angio­gra­phy did not ­show any pathol­o­gy.
In 17 out of 18 cas­es oper­at­ed on in ­order to ­clip the aneu­rysm, the CTA sup­plied all the infor­ma­tion need­ed for the sur­gery and it was pos­si­bile to recon­struct imag­es sim­i­lar to ­those of the sur­gi­cal ­field. This led to improve­ment in the pro­gram­ming of the sur­gi­cal inter­ven­tion; in 1 ­case ­only was it ­also nec­es­sary to per­form the DSA ­before the oper­a­tion.
Conclusions. CT angio­gra­phy, ­because it is non-inva­sive, ­easy to per­form, diag­nos­ti­cal­ly reli­able, and ­because the 3-D re-con­struc­tions ­offer the ­chance to ­create imag­es of the pos­sible oper­at­ing ­field, is the ­first-­choice ­test to be adopt­ed in the treat­ment of sub­arach­noid hae­mor­rhag­es, ­even ­though in ­some cas­es the use of the tra­di­tion­al angio­gra­phy is ­still nec­es­sary and ­should be car­ried out when­ev­er the CTA ­does not ­reveal vas­cu­lar mal­for­ma­tions.

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