Subarachnoid haemorrhage
Description
- Blood in the subarachnoid space - thunderclap headache + meningism +/- dec conscious state
- Non-traumatic SAH is aneurysmal until proven otherwise (trauma is the commonest cause of SAH overall)
Grading - do it on arrival, it drives prognosis
| WFNS | GCS | Focal deficit |
|---|---|---|
| I | 15 | No |
| II | 13-14 | No |
| III | 13-14 | Yes |
| IV | 7-12 | +/- |
| V | 3-6 | +/- |
- Hunt & Hess - clinical (I asymptomatic/mild headache -> V deep coma, decerebrate)
- Modified Fisher - CT blood volume; predicts delayed cerebral ischaemia, not rebleed
- Thick cisternal clot and intraventricular blood = highest DCI risk
6 more sections, plus exam facts
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