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sub-arachnoid haemorrhage (symptoms (sudden devastating occipital headache…
sub-arachnoid haemorrhage
causes
head trauma
berry aneurysm
arteriovenous malformation
neurological emergency, haemorrhage in subarachnoid space, cause stroke
risk factors
smoking
alcohol misuse
^BP
bleeding disorders
symptoms
sudden devastating occipital headache
vomiting
collapse
seizures
coma
sentinel headache
Ix
Ct
detects 90% of SAH in first 48h
LP
if CT is -ve and no contra
CSF uniformly bloody early on
becomes xanthochromic after several hours due to breakdown products of Hb (bilirubin)
Rx
close monitoring
BP, pupils, GCS
maintain cerebral perfusion
hydration
nimodipine
Ca2+ antagonist, reduce vasospasm
surgery
coiling, clipping