Diagnosis of spontaneous subarachnoid hemorrhage.
Spontaneous subarachnoid hemorrhage is usually the result of rupture of an intracranial saccular aneurysm or arteriovenous malformation. The hemorrhage is typically a cataclysmic event, heralded by severe headache, meningeal signs and neurologic dysfunction. About one-half of patients with aneurysmal rupture experience "sentinel headaches" days to weeks before a major hemorrhage. Diagnosis at this stage may permit treatment before the occurrence of a devastating neurologic event. Clinical suspicion of subarachnoid hemorrhage should be confirmed by computed tomographic evaluation. Initial treatment of patients with spontaneous subarachnoid hemorrhage includes resuscitation and/or stabilization, management of acute effects of the hemorrhage, and prompt referral for neurosurgical treatment.
Sawin
P D
PD
University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Loftus
C M
CM
D000465:Algorithms; D003937:Diagnosis, Differential; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis*; D012422:Rupture, Spontaneous; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy