Subarachnoid Haemorrhage Flashcards
1
Q
Define subarachnoid haemorrhage
A
Arterial haemorrhage into the subarachnoid space
2
Q
What are the causes/risk factors of subarachnoid haemorrhage?
A
Causes • Rupture of Berry aneurysm (Circle of Willis) – 85% • Perimesencephalic • AVM • Arterial dissection
Risk Factors • Hypertension • Smoking • Excess alcohol intake • Drugs e.g. cocaine • Polycystic kidney disease • Marfan’s syndrome • Ehlers-Danlos syndrome
3
Q
What are the symptoms of subarachnoid haemorrhage?
A
• Sudden onset severe headache “like being hit in the back of the head” (thunderclap headache) • Nausea • Vomiting • Neck stiffness • Photophobia • Reduced level of consciousness
4
Q
What are the signs of subarachnoid haemorrhage?
A
- Neck stiffness
- Kernig’s sign
- Pyrexia
- Papilloedema
Raised ICP
• 3rd or 6th cranial nerve palsy
• Hypertension
• Bradycardia
5
Q
What investigations are carried out for subarachnoid haemorrhage?
A
• Bloods - FBC - U&Es - ESR/CRP - Clotting profile - ↑ INR • CT head – hyperdensity • Lumbar puncture -↑ opening pressure - ↑ red cells - Xanthochromia (straw-coloured CSF) • CT angiography – identify source of bleeding, aneurysm