caa a22 4500 606171495 CHVBK 20210128100723.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10140-015-1306-9 doi (NATIONALLICENCE)springer-10.1007/s10140-015-1306-9 Ruptured intracranial aneurysm during pregnancy with false-negative computed tomography angiography findings: a case report [Elektronische Daten] [Yukihiro Goto, Toshihiko Ebisu, Katsuyoshi Mineura] A 34-year-old female was admitted at 34weeks of gestation with sudden onset of a severe headache accompanied by vomiting. Neurological examination revealed neck rigidity, and computed tomography (CT) of the brain revealed a subarachnoid hemorrhage (SAH). Although the hemorrhage was located primarily in the left Sylvian fissure, computed tomography angiography (CTA) performed immediately after CT did not reveal any obvious vascular abnormalities such as an intracranial aneurysm. An emergency cesarean section was performed, and a healthy infant was delivered. Cerebral digital subtraction angiography (DSA) was performed the day following surgery, which revealed a saccular aneurysm measuring 4.3mm × 2.4mm in the left middle cerebral artery. Left craniotomy and clipping of the aneurysm were performed. The clot around the aneurysm was relatively solid. This case report is of significance given that initial CTA was negative for SAH during pregnancy, suggesting the requirement for immediate DSA or another CTA in such cases. There are many previous reports on false-negative CTA findings or disappearance and reappearance of aneurysms in SAH patients, and various biophysical and dynamic parameters are suggested to cause such phenomena. However, there are no reports on similar occurrences during pregnancy. Although the precise cause remains unclear, multiple factors associated with homeostasis during pregnancy were possibly associated with the transient disappearance in this patient. American Society of Emergency Radiology, 2015 Subarachnoid hemorrhage nationallicence Pregnancy nationallicence Intracranial aneurysm nationallicence Computed tomography angiography nationallicence False negative nationallicence Goto Yukihiro Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine, Kawaramachi-Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan aut Ebisu Toshihiko Department of Neurosurgery, Nantan General Hospital, Yagi-cho, Yagiueno 25, 629-0197, Nantan City, Kyoto, Japan aut Mineura Katsuyoshi Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine, Kawaramachi-Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan aut Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 343-346 1070-3004 22:3<343 2015 22 10140 https://doi.org/10.1007/s10140-015-1306-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-015-1306-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Goto Yukihiro Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine, Kawaramachi-Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan aut NATIONALLICENCE 700 1- Ebisu Toshihiko Department of Neurosurgery, Nantan General Hospital, Yagi-cho, Yagiueno 25, 629-0197, Nantan City, Kyoto, Japan aut NATIONALLICENCE 700 1- Mineura Katsuyoshi Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine, Kawaramachi-Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 343-346 1070-3004 22:3<343 2015 22 10140