Before emergency aneurysm surgery, CTA or DSA? A single center experience

M. Zeynal, A. Yalcin

Department of Neurosurgery, Department of Radiology, Medical Faculty of Ataturk University, Erzurum, Turkey. dr.metezeynal@gmail.com

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• Neurosurgery

OBJECTIVE: Subarachnoid hemorrhage (SAH) due to an intracranial aneurysm is a life-threatening surgical emergency. After the diagnosis of SAH, physicians should find the reason for the bleeding. CT- Angiography (CTA) and Digital Subtraction Angiography (DSA) are techniques used to visualize the aneurysm. However, which one will surgeons prefer? In this study, we have compared these two radiological examinations.

PATIENTS AND METHODS: This study includes 58 patients diagnosed with SAH and intracranial aneurysm diagnosis based on CTA (n=30) and DSA (n=28). We evaluated the patients according to demographic properties, CTA and DAS findings, aneurysm location, Fisher score, postoperative complications, and Glasgow outcome score.

RESULTS: The most common location of aneurysms was the M1 level (48.3%). Patients in the DSA group had significantly more extended hospital stays (p= 0.021). There was no statistically significant difference between the two groups in complications.

CONCLUSIONS: Enhanced CT Technologies provide higher fidelity images and shorten hospital stays. With CTA, surgeons may gain time for an emergency surgical procedure. Despite the fact that DSA remains a significant factor in aneurysm diagnosis, DSA is an invasive procedure and needs more time to diagnose.

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