Prospective evaluation of cerebral angiography and computed tomography in cerebral haematoma

One hundred and two consecutive patients with cerebral haematoma were prospectively allocated to one of two groups according to their CT on admission. Group 1 patients were thought to have a high probability of an underlying structural lesion and underwent cerebral angiography acutely. If normal, th...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1994-10, Vol.57 (10), p.1180-1186
Main Authors: Halpin, S F, Britton, J A, Byrne, J V, Clifton, A, Hart, G, Moore, A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Blood Pressure - physiology
Cerebral Angiography
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - physiopathology
Child
Female
Hematoma - diagnostic imaging
Hematoma - physiopathology
Humans
Male
Medical sciences
Middle Aged
Neurology
Prospective Studies
Tomography, X-Ray Computed
Vascular diseases and vascular malformations of the nervous system
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Summary:One hundred and two consecutive patients with cerebral haematoma were prospectively allocated to one of two groups according to their CT on admission. Group 1 patients were thought to have a high probability of an underlying structural lesion and underwent cerebral angiography acutely. If normal, this was repeated at three months. Group 2 patients were thought not to have such a lesion and underwent angiography at three months. Patients older than the mean age of the study population, and hypertensive patients were much less likely to harbour an aneurysm or arteriovenous malformation than younger or normotensive patients (p < 0.01; sensitivity 87.9%, specificity 88.6%). An aneurysm or arteriovenous malformation was the cause of haemorrhage in 12.8% of hypertensive patients, in 30.9% of patients with haematoma involving the basal ganglia, and 18.2% of those with posterior fossa haemorrhage. Features of CT in isolation give a sensitivity of 77.2% and a specificity of 84.2%. Follow up angiography in group 1 showed an arteriovenous malformation in one of seven patients in whom the original study was normal. These results contrast sharply with data from previous retrospective studies. The decision to investigate a patient with cerebral haematoma should be primarily based on the patient's clinical condition, rather than on the site of haemorrhage.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.57.10.1180