Investigation of contrast and hemorrhage in the patients who had diagnostic and endovascular treatment intraarterial dsa prosedures on the unenhanced cranial CT obtained pre and postop period.

PURPOSE: Contrast can be seen in some patients control cranial CT, after both diagnostic and endovascular treatment DSA prosedures with intraarterial contrast material. In our study, two seperate groups of patients having spontaneous subarachnoid hemorrhage or intracerebral aneursym that undergo endovascular DSA procedure for treatment or just diagnostic purposes, we evaluated the CT?s without contrast material taken before and after these procedures and try to distinguish the cause of hyperdensity either by hemorrhage or contrast material used in DSA procedure.MATERIALS AND METHODS: Between May 2009 and May 2010, 32 spontaneous subarachnoid hemorrhage or intracranial aneurysm patients that undergo endovascular DSA procedures either for diagnostic or for treatment purposes in our hospitals Interventional Radiology Unit included to our study. 32 patients divided into two separate groups. The first group contains 16 patients that have been perfomed DSA only for diagnostic purposes. The second group also contains 16 patients but treated with endovascular DSA procedures. Before DSA procedure cranial CT witout contrast material performed to all patients. After the procedure at 1st, 6th and if needed 24th hours control CT?s taken. The frequency of hyperdensity due to contrast material, resolution pattern in brain and formation differences of these patterns in these patients was examined.SIGNS: In the first group, examination of the control cranial CT?s taken post procedure 1st hour, hyperdensity due to contrast material was seen only in 5 of 16 patients (%31,3) while in the second group 14 of 16 patients (%87,5) hyperdensity was observed. There was significant difference about hyperdensity ratio due to contrast material between two groups statistically (p<0,05).RESULTS: In the cranial CT?s taken after DSA for diagnostic or treatment purpose, hyperdensity due to contrast material can be observed in some patients. Distinction of this finding in control CT?s with hemorrhage, while contrast material resolves in CT examination is vital in follow up and treatment of these patients. We believe that high doses of contrast material given in DSA produce temporary changes in blood brain barrier that emerges hyperdensity in control CT?s as a result.