{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:35:31Z","timestamp":1779917731965,"version":"3.53.1"},"reference-count":35,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The yield of CT angiography (CTA) and MR angiography (MRA) in patients with subarachnoid hemorrhage (SAH) who have a negative initial catheter angiogram is currently not well understood. This study aims to determine the yield of CTA and MRA in a prospective cohort of patients with SAH and a negative initial catheter angiogram.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>From January 1, 2005, until September 1, 2010, the authors instituted a prospective protocol in which patients with SAH\u2014as documented by noncontrast CT or CSF xanthochromia and a negative initial catheter angiogram\u2014 were evaluated using CTA and MRA to assess for causative cerebral aneurysms. Two neuroradiologists independently evaluated the noncontrast CT scans to determine the SAH pattern (perimesencephalic or not) and the CT and MR angiograms to assess for causative cerebral aneurysms.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Seventy-seven patients were included, with a mean age of 52.8 years (median 54 years, range 19\u201388 years). Fifty patients were female (64.9%) and 27 male (35.1%). Forty-three patients had nonperimesencephalic SAH (55.8%), 29 patients had perimesencephalic SAH (37.7%), and 5 patients had CSF xanthochromia (6.5%). Computed tomography angiography demonstrated a causative cerebral aneurysm in 4 patients (5.2% yield), all of whom had nonperimesencephalic SAH (9.3% yield). Mean aneurysm size was 2.6 mm (range 2.1\u20133.3 mm). Magnetic resonance angiography demonstrated only 1 of these aneurysms. No causative cerebral aneurysms were found in patients with perimesencephalic SAH or CSF xanthochromia.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Computed tomography angiography is a valuable adjunct in the evaluation of patients with nonperimesencephalic SAH who have a negative initial catheter angiogram, demonstrating a causative cerebral aneurysm in 9.3% of patients.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.4.jns112306","type":"journal-article","created":{"date-parts":[[2012,6,8]],"date-time":"2012-06-08T14:06:00Z","timestamp":1339164360000},"page":"309-315","source":"Crossref","is-referenced-by-count":27,"title":["Diagnostic yield of computed tomography angiography and magnetic resonance angiography in patients with catheter angiography\u2013negative subarachnoid hemorrhage"],"prefix":"10.3171","volume":"117","author":[{"given":"Josser E.","family":"Delgado Almandoz","sequence":"first","affiliation":[{"name":"Division of Neuroradiology, Mallinckrodt Institute of Radiology,"},{"name":"Division of Interventional Neuroradiology, Abbott Northwestern Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharathi D.","family":"Jagadeesan","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Mallinckrodt Institute of Radiology,"},{"name":"Division of Interventional Neuroradiology, University of Minnesota School of Medicine, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Refai","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Moran","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Mallinckrodt Institute of Radiology,"},{"name":"Department of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DeWitte T.","family":"Cross","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Mallinckrodt Institute of Radiology,"},{"name":"Department of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Chicoine","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith M.","family":"Rich","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael N.","family":"Diringer","sequence":"additional","affiliation":[{"name":"Department of Neurology, and"},{"name":"Neurology\/Neurosurgery Intensive Care Unit, Washington University School of Medicine, Saint Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph G.","family":"Dacey","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin P.","family":"Derdeyn","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Mallinckrodt Institute of Radiology,"},{"name":"Department of Neurological Surgery,"},{"name":"Department of Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Zipfel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery,"},{"name":"Department of Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns112306","series-title":"AJNR Am J Neuroradiol","first-page":"696","article-title":"Negative CT angiography findings in patients with spontaneous subarachnoid hemorrhage: when is digital subtraction angiography still needed?","volume":"31","author":"Agid","year":"2010"},{"key":"b2-jns112306","series-title":"Neurosurgery","first-page":"1040","article-title":"Yield of further diagnostic work-up of cryptogenic subarachnoid hemorrhage based on bleeding patterns on computed tomographic scans","volume":"62","author":"Andaluz","year":"2008"},{"key":"b3-jns112306","series-title":"Neuroradiology","first-page":"772","article-title":"False-negative angiograms in subarachnoid haemorrhage due to intracranial aneurysms","volume":"39","author":"Bradac","year":"1997"},{"key":"b4-jns112306","series-title":"Emerg Radiol","first-page":"197","article-title":"Perimesencephalic subarachnoid hemorrhage: when to stop imaging?","volume":"18","author":"Cruz","year":"2011"},{"key":"b5-jns112306","series-title":"Radiology","first-page":"798","article-title":"Nontraumatic subarachnoid hemorrhage: value of repeat angiography","volume":"202","author":"du Mesnil de Rochemont","year":"1997"},{"key":"b6-jns112306","series-title":"Neuroradiology","first-page":"15","article-title":"The negative angiogram in subarachnoid haemorrhage","volume":"38","author":"Duong","year":"1996"},{"key":"b7-jns112306","series-title":"J Comput Assist Tomogr","first-page":"534","article-title":"Spontaneous subarachnoid hemorrhage with negative angiography: CT findings","volume":"16","author":"Farr\u00e9s","year":"1992"},{"key":"b8-jns112306","series-title":"J Neurol Sci","first-page":"14","article-title":"Non-traumatic subarachnoid hemorrhage with normal angiogram. 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