A clinical evaluation of computed tomography in patients with subarachnoid haemorrhage and multiple intracranial aneurysms.

A clinical usefulness of computed tomography was reviewed in 38 consecutive patients with subarachnoid haemorrhage and multiple intracranial aneurysms. CT helped in identification of ruptured aneurysm in more than 70% of cases (it pinpointed source of bleeding in 55% of patients and showed region of haemorrhage in 15% of cases). Its main limitation was inability to detect blood in subarachnoid space (SAS) in patients who were diagnosed later after bleeding (23%). Intracerebral haematoma or localized blood accumulated in SAS showed unequivocally the burst aneurysm. Symmetrical and especially asymmetrical distribution of blood in SAS were also helpful, though the former was misleading in two cases. Moreover, CT detected hypodense lesion of brain in 2 cases, widening of ventricular system in 12 patients and directly visualized aneurysm in 3 cases.