J Korean Neurosurg Soc.  2006 Feb;39(2):125-129.

Comparison of Computed Tomography Findings between Aneurysmal and Traumatic Subarachnoid Hemorrhage

• Lee JH
• Hong HJ
• Nam TK
• Hwang SN

Abstract

OBJECTIVE
The purpose of this study is to identify any differential point in computerized tomographic(CT) findings between aneurysmal subarachnoid hemorrhage(ASAH) and traumatic subarachnoid hemorrhage(TSAH), which sometimes make us not confident in differentiation.
METHODS
CT of 142 ASAH and 82 TSAH patients over the last 2 years were retrospectively reviewed. We evaluated the thickness of SAH, the laterality of sylvian cisternal hemorrhage, the location, the number of involved cisterns, and the associated other lesions between two types of SAH.
RESULTS
Suprasellar cisterns and sylvian cisterns were most prominently and frequently involved cisterns in ASAH but cortical sulci and sylvian cisterns were most frequently involved in TSAH. Intraventricular and intracerebral hemorrhage were frequently seen in ASAH. Thickness of SAH over 1 mm, bilateral sylvian SAH, multiple cisternal SAH were in favor of ASAH. The number of involved cisterns were more frequently seen in ASAH than in TSAH. In ASAH, bilateral sylvian hemorrhages were more frequently seen than in TSAH. Skull fracture, subdural hematoma, subgaleal hematoma, and hemorrhagic contusion were frequently associated with TSAH.
CONCLUSION
As a result of our study, the authors conclude that when IVH, hydrocephalus, thick SAH>1 mm bilateral sylvian SAH, and multiple cisternal SAH are seen in CT, immediate angiography should be performed to rule out cerebral aneurysms whether associated with other traumatic lesions or not.

Keyword

Aneurysmal subarachnoid hemorrhage; Traumatic subarachnoid hemorrhage; Computerized tomography; Differential diagnosis

MeSH Terms

Aneurysm*
Angiography
Cerebral Hemorrhage
Contusions
Diagnosis, Differential
Hematoma
Hematoma, Subdural
Hemorrhage
Humans
Hydrocephalus
Intracranial Aneurysm
Retrospective Studies
Skull Fractures
Subarachnoid Hemorrhage
Subarachnoid Hemorrhage, Traumatic*