Comparative evaluation of computed tomography and cerebral angiography in the management of subarachnoid haemorrhage.

Plain and contrast enhanced computed tomography (CT) scan of brain and cerebral angiography were done in 20 subjects of subarachnoid haemorrhage (SAH), diagnosed on the basis of clinical parameters and proved by cerebrospinal fluid (CSF) examination. Plain CT scan of brain confirmed the diagnosis of SAH in all the 20 (100%) cases, but was able to demonstrate the cause of SAH in 11(55%) cases only. Contrast CT scan provided additional information in 7 more cases. CT was also able to demonstrate the site and extent of bleeding, evidence of intraventricular bleeding and hydrocephalus. Cerebral angiography done in all the cases, confirmed the diagnosis in 14 (70%) cases diagnosed on CT and was able to give additional information in 4 more cases. It also showed excellent vascular details which were not possible with CT scan. It is concluded that enhanced CT scan should be done first in all the cases of SAH for preliminary scouting and angiography should be done where CT scan gives incomplete information or where surgical management is contemplated. Both the investigations were found to be complementary to each other.