Subarachnoid haemorrhage

@article{Gijn2007SubarachnoidH,
  title={Subarachnoid haemorrhage},
  author={Jan C van Gijn and Richard S. C. Kerr and Gabriel J E Rinkel},
  journal={The Lancet},
  year={2007},
  volume={369},
  pages={306-318}
}
Subarachnoid haemorrhage accounts for only 5% of strokes, but occurs at a fairly young age. Sudden headache is the cardinal feature, but patients might not report the mode of onset. CT brain scanning is normal in most patients with sudden headache, but to exclude subarachnoid haemorrhage or other serious disorders, a carefully planned lumbar puncture is also needed. Aneurysms are the cause of subarachnoid haemorrhage in 85% of cases. The case fatality after aneurysmal haemorrhage is 50%; one in… 
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Subarachnoid Hemorrhage: A Neurological Emergency
TLDR
Endovascular occlusion of the aneurysm with coils has been shown to be associated with better short- and long-term outcomes than surgical clipping in select patients and digital catheter angiography is the gold standard.
Effec tive headache management in the aneurysmal subarachnoid patient: a literature review
TLDR
This paper summarises the findings of a literature review conducted as part of a research study to examine existing practices in the assessment and management of headache in patients with aSAH in an Irish Neurosciences Centre, and demonstrates that despite a wealth of published literature on the diagnosis and management, evaluation andmanagement of its main symptom, headache, remains suboptimal and under-researched.
Isolated spinal artery aneurysm: a rare culprit of subarachnoid haemorrhage.
TLDR
The case of a 74-year-old man presenting with sudden onset of chest pain radiating to the neck and back, with subsequent headache and confusion is described and a thrombosed intradural spinal aneurysm with surrounding sentinel clot is demonstrated.
Magnesium in subarachnoid haemorrhage: proven beneficial?
TLDR
Magnesium is a promising agent to prevent the occurrence of secondary ischemia and to improve outcome in patients with SAH and two large phase Il trials are being conducted that will hopefully provide definite evidence whether magnesium treatment is beneficial in SAH patients.
The Clinical Aspects of Subarachnoid Hemorrhage
TLDR
The authors reviewed the recent advances in the clinical aspects of SAH and grading system of the available evidence is included.
Recognition and evaluation of nontraumatic subarachnoid hemorrhage and ruptured cerebral aneurysm.
TLDR
The most important risk factors for subarachnoid hemorrhage include cigarette smoking, hypertension, heavy alcohol use, and personal or family history of aneurysm or hemorrhagic stroke.
Computed tomography in subarachnoid haemorrhage : studies on aneurysm localization, hydrocephalus and early rebleeding
TLDR
The results confirmed that intraventricular haemorrhage (IVH) was the most consistent single risk factor for the development of acute HC and the non-contrast CT is a reliable method to detect the location of ruptured IA in patients with MCA and ACoA aneurysms.
Diagnosis, Medical Management, and Complications of Aneurysmal Subarachnoid Hemorrhage
TLDR
The clinical hallmark of aSAH, in an awake patient, is the complaint of the sudden onset of the “worst headache of life” (Bassi P, Acta Neurol Scand 84(4):277–81, 1991), which is preceded 7–30 days by a warning or sentinel headache.
Clinical Signs and Symptoms of Subarachnoid Hemorrhage Signs at presentation Patient experiences the worst headache of his or her life
N ontraumatic subarachnoid hemorrhage (SAH), usually from a ruptured aneurysm, often results in death or disability. Population-based mortality rates are as high as 45%. Although swift diagnosis and…
Clinical and cardiac features of patients with subarachnoid haemorrhage presenting with out-of-hospital cardiac arrest.
TLDR
The frequency of SAH in patients with all causes of OHCA was about 6%, and in resuscitated patients was about 15%.
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References

SHOWING 1-10 OF 159 REFERENCES
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Retrospective surveys of patients with subarachnoid haemorrhage suggest that minor episodes with sudden headache (warning leaks) may precede rupture of an aneurysm, and that early recognition and…
Subarachnoid haemorrhage: diagnosis, causes and management.
TLDR
Once ischaemia has occurred, treatment regimens such as a combination of induced hypertension and hypervolaemia, or transluminal angioplasty, are plausible, but of unproven benefit.
Detection of subarachnoid haemorrhage on early CT: is lumbar puncture still needed after a negative scan?
TLDR
In patients with sudden headache but normal CT a deferred lumbar puncture is necessary to rule out subarachnoid haemorrhage, even if CT is performed within 12 hours after the onset of symptoms.
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TLDR
Intraventricular bleeding, hydrocephalus and basofrontal haematomas contribute to the pathogenesis of delirium, through damage to anatomical networks subserving sustained attention, declarative memory and the expression of emotional behaviour.
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TLDR
In patients with acute severe headache, female sex, the presence of seizures, a history of loss of consciousness or focal symptoms, vomiting, or exertion increases the probability of ASAH, but these characteristics are of limited value in distinguishing ASAH from BTH.
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TLDR
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TLDR
Ten patients who presented with thunderclap headache mimicking subarachnoid haemorrhage, who appeared to have CVST are described.
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TLDR
Although rebleeding and mortality or severe disability at discharge were more frequent in these patients, seizures were not a significant predictor of prognosis, and Hemiparesis, Hunt’s grade >3, the amount of subarachnoid blood and the presence of an aneurysm were significantly more frequent.
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Acute confusional state as presenting feature in aneurysmal subarachnoid hemorrhage: frequency and characteristics
TLDR
Keys to early diagnosis of SAH in patients presenting with ACS are a preceding period of loss of consciousness and severe headache on neurological assessment, and one per 70 patients with SAH presents with ACS.
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