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Normal cerebral arteriography in patients with spontaneous subarachnoid hemorrhage

Departments of Neurology (Dr. West), Radiology (Drs. Mani and Eisenberg), and Neurosurgety (Dr. Tuerk), University of California School of Medicine and the Veterans Administration Hospital, San Francisco, and the Department of Radiology, Kaiser Foundation Hospital, Redwood City, California (Dr. Sucker).

Previous studies have reported that 18 to 27 percent of patients with spontaneous subarachnoid hemorrhage have normal cerebral arteriograms. Our series of 220 patients from three hospitals demonstrated normal arteriograms in only 16 (7 percent). Recent improvements in neuroradiologic techniques, such as femoral catheterization, magnification angiography, oblique and basal projections, and subtraction most probably contribute to the improved yield. Nonvisualization of a cerebral aneurysm probably represents the most common explanation for a normal cerebral arteriogram.

Reprint requests should be addressed to Dr. Mani, Radiology Service, Veterans Administration Hospital, 4150 Clement Street, San Francisco, CA 94121.

Supported in part by NIH grant NS-11539.

Received for publication July 9, 1976.