Value of CT angiography for the detection of intracranial vascular lesions in patients with acute severe headache
- 892 Downloads
To retrospectively investigate the prevalence and characteristics of intracranial vascular lesions in patients with acute severe headache with the use of CT angiography (CTA).
We systematically searched for neurologically intact patients with acute severe headache and normal unenhanced head CT. The study group consisted of 512 patients; 251 male; mean age 46.2 ± 12.4 years. All patients underwent CTA between 1 day and 2 months after the headache attack. CTA images were interpreted by two experienced neuroradiologists for the presence of vascular lesions.
Thirty-four (6.6 %) of the 512 patients had intracranial vascular lesions on CTA, including 33 aneurysms (2 patients had 2 aneurysms each), 2 moyamoya disease and 1 arterial dissection. No gender- or age-related differences were found. Aneurysms arose most commonly on the internal carotid artery (n = 12), followed by the anterior communicating artery (n = 7), and the middle cerebral artery (n = 7). Maximal diameters ranged from 2.0 to 13.1 mm (mean, 3.9 ± 2.6 mm).
CTA is a feasible tool for diagnosing intracranial vascular lesions in patients with acute severe headache. The prevalence of vascular lesions in our series was 6.6 %, which is higher than that predicted in the general population.
• Unruptured cerebral aneurysms may be a cause of acute severe headache
• CTA assesses intracranial vascular lesions in patients with acute severe headache
• The prevalence of vascular lesions in our series of patients was 6.6 %
KeywordsIntracranial aneurysm CT angiography Headache Screening Prevalence
- 19.Tolias CM, Choksey MS (1996) Will increased awareness among physicians of the significance of sudden agonizing headache affect the outcome of subarachnoid hemorrhage? Coventry and Warwickshire study: audit of subarachnoid hemorrhage (establishing historical controls), hypothesis, campaign layout and cost estimation. Stroke 27:807–812PubMedCrossRefGoogle Scholar
- 34.Yoon DY, Lim KJ, Choi CS, Cho BM, Oh SM, Chang SK (2007) Detection and characterization of intracranial aneurysms with 16-channel multidetector row CT angiography: a prospective comparison of volume-rendered images and digital subtraction angiography. AJNR Am J Neuroradiol 28:60–67PubMedGoogle Scholar
- 35.McKinney AM, Palmer CS, Truwit CL, Karagulle A, Teksam M (2008) Detection of aneurysms by 64-section multidetector CT angiography in patients acutely suspected of having an intracranial aneurysm and comparison with digital subtraction and 3D rotational angiography. AJNR Am J Neuroradiol 29:594–602PubMedCrossRefGoogle Scholar