Subarachnoid haemorrhage Flashcards
Definition of subarachnoid haemorrhage
Arterial haemorrhage into the subarachnoid space
Most common aetiology of SAH
Rupture of aneurysm at base of brain (usually circle of Willis)
History of subarachnoid haemorrhage (4)
Sudden onset severe headache
Nausea, vomiting, neck stiffness
Photophobia
Decreased level of consciousness
Signs of increased ICP (3)
Papilloedema, III or IV nerve palsy
What does CT typically show in SAH? (3)
Hyperdense areas in base of skull; also may see intraparenchymal/intraventricular haemorrhage
How can ischaemia result from SAH? (2)
Vasospasm and reduced perfusion
Complications of SAH (3)
Obstructive hydrocephalus
Rebleeding
Vasospasm
Management of SAH (3)
Angiography to locate bleeding; surgical coiling/wrapping; nimodipine post-op (calcium blocker)
Where might blood be seen on CT (other than within basal structures and ventricles) (2)
Within the Sylvian fissures (lateral sulcus)
Interhemispheric fissure
When is a lumbar puncture performed in suspected SAH and what is it looking for?
after 12 hours; zanthochromia (yellow discolouration)