Central nervous system disorders

IV./3.4.: Digital subtraction angiography – DSA

This is the imaging method of the therapeutic intervention, since CTA is performed to diagnose/localise and even measure the aneurysm. DSA must be performed in all four vessels due to the possibility of multiple aneurysms. Radiological intervention/embolisation is an important therapeutic method nowadays. An important reason to perform a catheter intervention against an opened craniotomy is the unfavourable anatomic situation (e.g. basilar apex aneurysm) or the high risk of the patient status. In case of vasospasm, administration of selective intraarterial spasmolytics can be also necessary.

IV./3.5.: Ultrasound – US

Follow-up transcranial Doppler examination has a role in the detection of vasospasm. Normal velocity in the middle cerebral artery is 30-80 cm/sec, in case of mild vasospasm 120, in case of severe vasospasm 200 cm/sec velocity can be reached as well).