The predicted value of arteriography in nontraumatic intracerebral hemorrhage.

We retrospectively assessed the diagnostic value of cerebral arteriography for the search of an etiology in 102 patients with nontraumatic intracerebral hemorrhages evaluated between 1980 and 1985. Arteriography was diagnostic in 22 of 50 non-hypertensive patients and in only 6 of 47 hypertensive patients. Five patients with a bleeding diathesis had normal arteriography. From the total group, we found 12 saccular aneurysms, 9 arteriovenous malformations, 3 cases of moya-moya and 3 instances of superior sagittal sinus thrombosis. One patient had metastatic choriocarcinoma. Sites of hemorrhage among all patients with diagnostic arteriograms were: lobar 19, intraventricular 5, thalamic 2, caudate 1, and corpus callosum 1. Lobar hemorrhages in the non-hypertensive group and intraventricular hemorrhages in hypertensive individuals had the highest yield of arteriographic abnormalities. We believe cerebral arteriography is indicated in non-hypertensive patients with lobar hemorrhages. Most hypertensive patients, in particular those with putaminal hemorrhages, do not require arteriography.