Subarachnoid Haemorrhage

Question 1

what is a subarachnoid haemorrhage

Answer 1

arterial haemorrhage into the subarachnoid space

Question 2

what is the subarachnoid layer

Answer 2

between the arachnoid and pia mater

Question 3

cause of subarachnoid haemorrhage

Answer 3

rupturing of aneurysms at the base of the brain (Circle of Willis)- Berry aneurysms

Question 4

what are berry aneurysms

Answer 4

aneurysms that occur in the circle of willis

Question 5

risk factors of subarachnoid haemorrhage

Answer 5

hypertension, smoking, excess alcohol intake

Question 6

presenting symptoms of a subarachnoid haemorrhage

Answer 6

sudden-onset headache (‘like a blow to the back of the head’), nausea/ vomiting, neck stiffness, photophobia, reduced level of consciousness

Question 7

similarities and differences between subarachnoid haemorrhage and meningitis

Answer 7

similarities; headache, neck stiffness, photophobia, reduced level of consciousness

difference; subarachnoid haemorrhage will not present with a rash OR fever

Question 8

signs on physical examination of subarachnoid haemorrhage

Answer 8

raised ICP (papilloedema, nerve palsies, hypertension, bradycardia)

meningism (neck stiffness, Kernig’s sign)

focal neurological signs (cranial nerve IV or III palsies)

Question 9

investigations

Answer 9

CT, MRI, lumbar puncture, cerebral angiography to demonstrate the location of the ruptured aneurysm

Question 10

management of subarachnoid haemorrhage

Answer 10

aneurysm will usually be secured by endovascular coiling or surgical clipping