Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Apr;259(4):649-52.
doi: 10.1007/s00415-011-6228-1. Epub 2011 Sep 8.

Chance of aneurysm in patients suspected of SAH who have a 'negative' CT scan but a 'positive' lumbar puncture

P Horstman  1 , F H H Linn, H A M Voorbij, G J E Rinkel
Affiliations

Chance of aneurysm in patients suspected of SAH who have a 'negative' CT scan but a 'positive' lumbar puncture

P Horstman et al. J Neurol. 2012 Apr.

Abstract

In patients with sudden severe headache and a negative computed tomography (CT) scan, a lumbar puncture (LP) is performed to rule in or out a subarachnoid haemorrhage (SAH), but this procedure is under debate. In a hospital-based series of 30 patients with sudden headache, a negative CT scan but a positive LP (defined as detection of bilirubin >0.05 at wavelength 458 nm), we studied the chance of harbouring an aneurysm and the clinical outcome. Aneurysms were found in none of both patients who presented within 3 days, in 8 of the 18 (44%) who presented within 4-7 days and in 5 of the 10 (50%) who presented within 8-14 days. Of the 13 patients with an aneurysm, 3 (23%) had poor outcome. In patients who present late after sudden headache, the yield in terms of aneurysms is high in those who have a positive lumbar puncture. In patients with an aneurysm as cause of the positive lumbar puncture, outcome is in the same range as in SAH patients admitted in good clinical condition.

PubMed Disclaimer

References

    1. Linn FHH, Wijdicks EFM, van der Graaf Y, Weerdesteyn-van Vliet FAC, Bartelds AIM, van Gijn J. Prospective study of sentinel headache in aneurysmal subarachnoid haemorrhage. Lancet. 1994;344:590–593. doi: 10.1016/S0140-6736(94)91970-4. - DOI - PubMed
    1. Byyny RL, Mower WR, Shum N, Gabayan GZ, Fang S, Baraff LJ. Sensitivity of noncontrast cranial computed tomography for the emergency department diagnosis of subarachnoid hemorrhage. Ann Emerg Med. 2008;51:697–703. doi: 10.1016/j.annemergmed.2007.10.007. - DOI - PubMed
    1. Cortnum S, Sorensen P, Jorgensen J. Determining the sensitivity of computed tomography scanning in early detection of subarachnoid hemorrhage. Neurosurgery. 2010;66:900–902. - PubMed
    1. Edlow JA, Malek AM, Ogilvy CS. Aneurysmal subarachnoid hemorrhage: update for emergency physicians. J Emerg Med. 2008;34:237–251. doi: 10.1016/j.jemermed.2007.10.003. - DOI - PubMed
    1. Coats TJ, Loffhagen R. Diagnosis of subarachnoid haemorrhage following a negative computed tomography for acute headache: a Bayesian analysis. Eur J Emerg Med. 2006;13:80–83. doi: 10.1097/01.mej.0000190277.92731.52. - DOI - PubMed