Diagnosis of ruptured cerebral aneurism with computerized tomography angiography

Objective To evaluate the value of computerized tomography angiography (CTA) for the diagnosis of ruptured cerebral aneurism. Methods Forty patients on suspicion of ruptured cerebral aneurism had CTA with the Philips Tomoscan AVP1 spiral CT . The imagines displayed with the techniques of maximum intensity projection (MIP) and the shaded surface display (SSD) after the data proceeded by computer station were read both by radiology physician and neurosurgeon. Results Twenty-eight aneurysms were found in 25 cases in 40 cases studied, including 13 cases of anterior communicating arterial aneurysm (ACoA) , 3 case of intracranial carotid arterial aneurysm, 2 case of posterior communicating arterial aneurysm (PCoA) , 2 case of middle cerebral arterial aneurysm ( MA) , 1 case of ophthalmic arterial aneurysm, 1 case of basilar arterial aneurysm (BA) , 1 case of left middle cerebral artery aneurysm (MCA) and 2 cases of PCoA accompanied with minimum sprout-like aneurysm at collateral paraclinoid carotid artery. Twenty patients had craniotomy for clipping their aneurysms. Fifteen cases were operated without conventional cerebral angiography after CTA, in which all the finding were identical with preoperative examination. Conclusion CTA may be a quick, relative simple, safe and reliable tool of choice for the diagnosis and emergency treatment of ruptured aneurysm.