Clinical Study of the Pattern of Aneurysmal Subarachnoid Hemorrhage

Objective To evaluate the morphological features of aneurysmal subarachnoid hemorrhage on computed tomography (CT) scan, then to forcast the location of intracranial ruptured aneurysms on the basis of the CT results. Methods The manifestation of CT and digital subtraction angiography (DSA) in eighty-two patients with aneurysmal subarachnoid hemorrhage were analyzed. The relationship between the subarachnoid hemorrhage morphology and the location of the intracranial aneurysm was found. Results The distribution of the hemorrhage caused by ruptured aneurysms located on the anterior cerebral artery (ACA), anterior communicating artery (ACoA) and middle cerebral artery (MCA) are special. The hemorrhage mainly distributes on the anterior longitudinal cistern, sylvian cistern. Sometimes there are hematomas on those cisterns. That caused by ruptured aneurysms located on the internal cerebral artery (ICA) and posterior communicating cerebral artery (PCoA) are various. But the typical hemorrhage distribute on the super-sellar cistern and sylvian cistern. The hemorrhage pattern of ruptured aneurysms on the posterior cerebral circulate such as the posterior cerebral artery (PCA), basic artery (BA), vertebral artery (VA) and anterior inferior cerebellum artery (AICA) has its own characteristics, but it's difficult to be distinguished with the nonaneurysmal hemorrhage around the brain-stem. The hemorrhage distribute on the interpeduncular cistern, ambient cistern, quadrigeminal cistern, superior and under cerebellar tentorium, prepontine cistern and lateral cerebellomedullary cistern. Conclusion We can predict some ruptured aneurysms located on ACoA, ACA and MCA according to the quantity and distribution of subarachnoid hemorrhage on CT scan. It's difficult to distinguished the non-aneurysmal hemorrhage around the brain-stem with the aneurysmal hemorrhage caused by ruptured PCA, VA, BA and AICA aneurysms. It isn't accurate to predict the ruptured ICA and PCoA aneurysms because of the various hemorrhage morphology.