{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:25:10Z","timestamp":1784625910129,"version":"3.55.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,5]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014It is important to recognize a perimesencephalic pattern of hemorrhage in patients with subarachnoid hemorrhage (SAH), because in 95% of these patients the cause is nonaneurysmal and the prognosis is excellent. The purpose of this study was to investigate whether CT angiography can accurately exclude vertebrobasilar aneurysms in patients with perimesencephalic patterns of hemorrhage and therefore replace digital subtraction angiography (DSA) in this setting.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014In 40 patients with posterior fossa SAH as shown on unenhanced CT, 2 radiologists independently evaluated unenhanced CT for distinguishing between perimesencephalic and nonperimesencephalic pattern of hemorrhage and assessed CT angiography for detection of aneurysms. All patients subsequently underwent DSA or autopsy.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014Observers agreed in 38 of 40 patients (95%) in differentiating perimesencephalic and nonperimesencephalic patterns of hemorrhage on unenhanced CT. On the CT angiograms, both observers detected a vertebrobasilar aneurysm in 16 patients and no aneurysm in 24 patients. These findings were confirmed by DSA or autopsy. No patients with a perimesencephalic pattern of hemorrhage were found to have an aneurysm on either CT angiography or DSA.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Good recognition of a perimesencephalic pattern of hemorrhage is possible on unenhanced CT, and CT angiography accurately excludes and detects vertebrobasilar aneurysms. DSA can be withheld in patients with a perimesencephalic pattern of hemorrhage and negative CT angiography.\n          <\/jats:p>","DOI":"10.1161\/01.str.30.5.1103","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1103-1109","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":86,"title":["Perimesencephalic Hemorrhage"],"prefix":"10.1161","volume":"30","author":[{"given":"Birgitta K.","family":"Velthuis","sequence":"first","affiliation":[{"name":"From the Departments of Radiology (B.K.V., L.M.P.R., T.D.W., M.S. v L.) and Neurology (G.J.E.R.), Utrecht University Hospital, Utrecht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrie\u0308l J. E.","family":"Rinkel","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (B.K.V., L.M.P.R., T.D.W., M.S. v L.) and Neurology (G.J.E.R.), Utrecht University Hospital, Utrecht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lino M. P.","family":"Ramos","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (B.K.V., L.M.P.R., T.D.W., M.S. v L.) and Neurology (G.J.E.R.), Utrecht University Hospital, Utrecht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoor D.","family":"Witkamp","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (B.K.V., L.M.P.R., T.D.W., M.S. v L.) and Neurology (G.J.E.R.), Utrecht University Hospital, Utrecht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten S.","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (B.K.V., L.M.P.R., T.D.W., M.S. v L.) and Neurology (G.J.E.R.), Utrecht University Hospital, Utrecht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"829","volume":"12","year":"1991","unstructured":"Rinkel GJE, Wijdicks EFM, Vermeulen M, Ramos LMP, Tanghe HLJ, Hasan D, Meiners LC, van Gijn J. 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