CT Differential Diagnosis of Traumatic and Aneurysmal Rupture Subarachnoid Hemorrhage

LIN Wenmin; KANG Yaqing

doi:10.13919/j.issn.2095-6274.ZHJY202411066

Abstract：Objective To compare and analyze the CT manifestations of subarachnoid hemorrhage(SAH)caused by trauma and aneurysmal rupture.Methods A retrospective analysis was conducted on the clinical data of 120 patients with subarachnoid hemorrhage admitted to Yongchun County Hospital between January 2022 and De-cember 2023.Of these,60 patients had traumatic subarachnoid hemorrhage(trauma group),and 60 had aneurysmal subarachnoid hemorrhage(aneurysmal group).The extent and distribution of blood accumulation in the two groups were compared.Results In the trauma group,the majority of patients had a blood accumulation score of ≤ 5,a significantly higher proportion than in the aneurysmal group(P＜0.001).Conversely,the aneurysmal group showed a higher proportion of patients with a blood accumulation score of ≥ 10(P＜0.001).The average blood accumulation score was significantly lower in the trauma group compared to the aneurysmal group(P＜0.001).In terms of blood distribution,the aneurysmal group exhibited more extensive blood accumulation in regions such as the third ventricle(P=0.002),fourth ventricle(P＜0.001),sylvian fissures(P=0.012),basal cisterns(P＜0.001),cerebellomedullary cistern(P=0.007),interpeduncular cistern(P＜0.001),and others,with significant differences observed between the two groups(P＜0.001).Conclusion CT imaging is valuable in distinguishing aneurysmal from traumatic subarachnoid hemor-rhage.Aneurysmal SAH is characterized by a more extensive blood accumulation,predominantly centered around the skull base and extending to adjacent brain ventricles,cisterns,and sulci.In contrast,traumatic SAH typically presents with more localized blood accumulation,primarily at the cortical level.