TY - JOUR
T1 - Thrombosis and subsequent recanalization of a ruptured intracranial aneurysm in 2 children, demonstrating the value of repeating catheter angiography after an initial negative study
T2 - Report of 2 cases
AU - Valle, Edison P.
AU - Tamargo, Rafael J.
AU - Gailloud, Philippe
PY - 2010/4
Y1 - 2010/4
N2 - The cases of 2 children with true aneurysmal subarachnoid hemorrhages (SAHs) and initial false-negative angiograms are reported. In both cases, the initial angiogram was of adequate technical quality and included the projections on which aneurysms were later documented. There was no significant vasospasm at the time of initial angiography; therefore, transient aneurysm sac thrombosis was the most likely explanation for the initial false-negative studies. It is particularly interesting to note that 1 of the 2 patients had a pattern of hemorrhage compatible with the most limited definition of a perimesencephalic SAH, that is, a small prepontine cistern hemorrhage. If a second angiogram had been deemed unnecessary based on that criterion alone, a ruptured basilar tip aneurysm would have escaped detection and treatment.
AB - The cases of 2 children with true aneurysmal subarachnoid hemorrhages (SAHs) and initial false-negative angiograms are reported. In both cases, the initial angiogram was of adequate technical quality and included the projections on which aneurysms were later documented. There was no significant vasospasm at the time of initial angiography; therefore, transient aneurysm sac thrombosis was the most likely explanation for the initial false-negative studies. It is particularly interesting to note that 1 of the 2 patients had a pattern of hemorrhage compatible with the most limited definition of a perimesencephalic SAH, that is, a small prepontine cistern hemorrhage. If a second angiogram had been deemed unnecessary based on that criterion alone, a ruptured basilar tip aneurysm would have escaped detection and treatment.
KW - Aneurysm thrombosis
KW - Digital subtraction angiography
KW - False-negative angiogram
KW - Perimesencephalic subarachnoid hemorrhage
KW - Subarachnoid hemorrhage
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U2 - 10.3171/2009.10.PEDS0966
DO - 10.3171/2009.10.PEDS0966
M3 - Article
C2 - 20367338
AN - SCOPUS:77950550659
SN - 1933-0707
VL - 5
SP - 346
EP - 349
JO - Journal of Neurosurgery: Pediatrics
JF - Journal of Neurosurgery: Pediatrics
IS - 4
ER -