Computed tomographic findings in ruptured basilar tip aneurysms

Abstract

Background: Computed tomography (CT) plays an important role in the evaluation of acute non- traumatic subarachnoid hemorrhage (SAH), mostly due to ruptured aneurysms. Knowledge of the common CT pattern of hemorrhage in ruptured basilar tip aneurysms would be beneficial for diagnostic evaluation and treatment planning.

Objective: To characterize the common CT findings pattern of patients who had ruptured basilar tip aneurysms at King Chulalongkorn Memorial Hospital (KCMH) between January 1, 2011, and December 31, 2015.

Methods: Sixteen patients diagnosed with ruptured basilar tip aneurysm were recruited in this study. The CT findings, demographic data, clinical signs and symptoms, as well as cerebral angiographic findings associated with ruptured basilar tip aneurysms were retrospectively reviewed from the Hospital Information System (HIS) and Picture Archiving and Communication Systems (PACS).

Results: The most common CT findings in ruptured basilar tips aneurysms were subarachnoid hemorrhage (SAH) in the interpeduncular cistern (88.0%) followed by a prepontine cistern and Sylvian cistern (81.0%) and cerebral convexities (75.0%). More than half of the patients (56.0%) were classified as grade 4 according to modified Fisher’s SAH grading system. Intraventricular hemorrhage (IVH) was noted in 9 of 16 patients (56.0%). IVH was observed in the lateral, third and fourth ventricles in 78.0%, 67.0%, and 67.0%, respectively. Hydrocephalus was demonstrated in 14 of 16 patients (88.0%).

Conclusion: Our study reveals the common CT findings together with the demographic data, clinical presentation and cerebral angiographic findings in ruptured basilar tip aneurysms in 16 patients. The results can be used to predict ruptured basilar tip aneurysms in common CT findings for proper management in order to reduce mortality rate and disability.