Subarachnoid Haemorrhage - SAH

Sudden onset headache at back of head

Due to:
Rupture of aneurysm, AV malformation, maybe trauma but not true

8/100000

Atherosclerotic risk factors

Signs and symptoms

Headache
Neck stiffness - Kernig's sign - chemical meningitis
Impaired consciousness
Cranial nerve signs
Hemiplegia
Sentinel headache - before actual headache


Grade 1-5
5 = 100% (prolonged coma)
1 = 0% (no signs)

Prognosis
Overall mortality 35-50%, most die within 1 month
Worse with aneurysm better with AV malformation
Rebleeding very common


Investigations

CT
Lumbar puncture for blood and xanthochromia (yellow CSF)


Treatment - Coiling > clipping