Subarachnoid Haemorrhage Flashcards

1
Q

Define subarachnoid haemorrhage

A

Arterial haemorrhage into the subarachnoid space

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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
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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
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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

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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
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