Acta Neurochirurgica

, Volume 87, Issue 1–2, pp 22–30 | Cite as

CT-findings in haemorrhages from aneurysms of the anterior communicating artery: Correlation with angiography and clinical course

  • P. Stoeter
  • H. -J. Reulen
  • U. Groeger


CT findings, angiography and clinical course were analyzed in a series of 31 patients with a recent subarachnoid haemorrhage (SAH) from an aneurysm of the anterior communicating artery (ACoAA). It is shown that 3 types of bleedings can be distinguished according to the CT findings. In thefirst group (52%), suffering a mild or moderate bleeding into the basal cisterns and/or the cisterna lamina terminalis, the aneurysm mostly points downwards and is orientated straight in the midline, the Hunt and Hess Grade at admission is I or II and the prognosis following early surgery is good. In thesecond group (29%), the aneurysm mostly is orientated towards one side, additional bleeding occurs into the gyrus rectus and the mediobasal frontal lobe, they are in HH Grade II and III and the prognosis following surgery also is relatively good. Ingroup three (19%) however, the aneurysm points upwards, they present with severe bleeding into the cisterna lamina terminalis, the cavum septum pellucidum and rupture into the putamen, hypothalamus and the ventricle. In this group, the HH grade at admission is IV or V and the prognosis is extremely unfavourable. It is concluded, that this classification may be used for decision on early surgery.


ACoAA CT findings and prognosis subarachnoid haemorrhage 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Brismar J (1979) Computertomography as the primary radiologic procedure in acute subarachnoid haemorrhage. Acta radiol (Diagn) 20: 849–864Google Scholar
  2. 2.
    Crompton M (1961) Intracerebral haematomas complicating ruptured cerebral berry aneurysms. J Neurol Neurosurg Psychiatry 25: 378–386Google Scholar
  3. 3.
    Fisher C, Kistler JP, Davis JH (1980) Relation of cerebral vasospasm to subarachnoid haemorrhage visualized by computerized tomographic scanning. Neurosurgery 6: 1–9PubMedGoogle Scholar
  4. 4.
    Hunt W, Hess R (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 14–20PubMedGoogle Scholar
  5. 5.
    Kendall B, Lee B, Claveria E (1976) Computerized tomography and angiography in subarachnoid haemorrhage. Br J Radiol 49: 483–501PubMedGoogle Scholar
  6. 6.
    Liliequist B, Lindquist U, Vald, Marsson E (1977) Computed tomography and subarachnoid haemorrhage. Neuroradiology 14: 21–26PubMedGoogle Scholar
  7. 7.
    Ljunggren B, Säveland H, Brand L (1983) Causes of unfavourable outcome after early aneurysm operation. Neurosurgery 13: 629–633PubMedGoogle Scholar
  8. 8.
    Ljunggren B, Brand L, Säveland H, Nilson PE, Cronquist S, Anderson KE, Vinge E (1984) Outcome in 60 consecutive patients treated with early aneurysm operation and intravenous nimodipine. J Neurosurg 61: 864–873PubMedGoogle Scholar
  9. 9.
    Modesti L, Binet E (1978) Value of computed tomography in the diagnosis and management of subarachnoid haemorrhage. Neurosurgery 3: 151–156PubMedGoogle Scholar
  10. 10.
    Scotti G, Ethier R, Melancon D, Terbrugge K, Tchang S (1977) Computed tomography in the evaluation of intracranial aneurysms and subarachnoid haemorrhage. Radiology 123: 85–90PubMedGoogle Scholar
  11. 11.
    Suzuki J, Domatsu S, Sato T, Sakurai Y (1980) Correlation between CT findings and subsequent development of cerebral infarction due to vasospasm in subarachnoid haemorrhage. Acta Neurochir (Wien) 55: 63–70Google Scholar
  12. 12.
    Taveras JM, Wood EH (1976) Diagnostic neuroradiology, vol 2, 2nd ed. Williams & Wilkins, BaltimoreGoogle Scholar
  13. 13.
    Yock DH, Larson DH (1980) Computed tomography of haemorrhage from anterior communicating artery aneurysms with angiographic correlation. Radiology 134: 399–407PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • P. Stoeter
    • 1
  • H. -J. Reulen
    • 2
  • U. Groeger
    • 1
  1. 1.Department of NeuroradiologyElisabethenkrankenhausRavensburgGermany
  2. 2.Department of NeurosurgeryUniversity of Berne, InselspitalBerneSwitzerland

Personalised recommendations