Intracranial aneurysms and subarachnoid hemorrhage: Clinical studies on diagnosis and treatment

Computerized tomography angiography (CTA) can be performed quicker, safer and cheaper than digital subtraction angiography (DSA) in patients after aneurysmal subarachnoid hemorrhage (SAH). However, DSA is still regarded as the gold standard in the diagnosis of intracranial ruptured aneurysms. No studies have specifically addressed the value of CTA in planning of endovascular treatment of ruptured aneurysms. Mathieu van der Jagt investigates the diagnostic value of CTA for endovascular treatment compared with DSA, in cooperation with Radiology. He hypothesizes is that, at least in a subset of patients, CTA suffices and DSA can be omitted in the planning of endovascular treatment. Another project concerns a systematic review on rupture rate of unruptured intracranial aneurysms (UIAs), estimating the rupture rate of UIAs based on the available observational studies. The statistical method used will allow for correction for methodological quality per study, lea! ding to an estimate of rupture rate that is based on less biased data. The PhD project also evaluates the localizing value of blood distribution on CTA for the location of ruptured intracranial aneurysm; it includes a cohort study on the impact of early surgery on overall outcome after aneurysmal SAH.