MR Imaging of the Brain 1 Year after Aneurysmal Subarachnoid Hemorrhage: Randomized Study Comparing Surgical with Endovascular Treatment

Purpose: To prospectively evaluate, with magnetic resonance (MR) imaging, long-term outcome of the brain after endovascular versus neurosurgical treatment for aneurysmal subarachnoid hemorrhage (aSAH). Materials and Methods: Institutional review board approval and informed consent were obtained. One hundred sixty-eight (77 men, 91 women; mean age ± standard deviation, 51 years ± 13) patients were randomly assigned to surgical versus endovascular treatment of the ruptured aneurysm with 138 (67 endovascular, 71 surgical) MR examinations 1 year after aSAH. The presence, localization, volumes, and cause of lesions were analyzed with χ2, Mann-Whitney U, and Student t tests. Furthermore, correlation between MR-detectable brain parenchymal high-signal intensity (SI) lesions on T2- and intermediate-weighted MR images and neuropsychologic outcome was evaluated by using Spearman correlation coefficient. Results: Only 44 (31.9%) of 138 patients had no lesions associated with aSAH. According to intention to treat, le...