Student Name: Faisal Alhamed

Academic No: 439050271

Table Of Contents:

Introduction

Diagnosis

Complications
Of Subarachnoid
Hemorrhage

Subarachnoid
Hemorrhage
Patient Care

Treatment
Introduction:
A 25-year-old man arrived at the emergency room with a sudden headache
(thunderclap headache).
The headache reached its peak within a minute and lasted for an hour.
The young man smoked and consumed alcohol and had a previous high blood
pressure.
By examining the patient, we found:
1. Pain in moving the neck forward.
2. Nausea and vomiting.
3. photophobia.
4. disturbance of consciousness.

Clinical signs and symptoms seen in

subarachnoid hemorrhage
Diagnosis:
Sudden severe headache points to subarachnoid hemorrhage.
To diagnose subarachnoid hemorrhage, we perform the following procedures:
1. Computed tomography.
2. MRI.
3. Lumbar puncture.
4. Arteriography

CT scan is the first and most rapid investigation available for diagnosis and shows
hemorrhage as high intensity within the gyri of the brain.
If the CT scan is negative and we have a strong suspicion of subarachnoid hemorrhage,
we resort to lumbar puncture.
After determining the presence of subarachnoid hemorrhage, we resort to determining
the cause of this hemorrhage through angiography, as the most common cause of
subarachnoid hemorrhage is the rupture of a cystic aneurysm.
Complications Of Subarachnoid Hemorrhage:
1. Recurrent bleeding.
2. 2. Vasoconstriction.
 CT image without injection, shown
Subarachnoid hemorrhage

A DSA image showing an aneurysm

It is a source of Subarachnoid
hemorrhage
Subarachnoid Hemorrhage Patient Care:
1. Most medical centers begin with intravenous fluid administration of 2 liters of
saline solution, proper maintenance of fluids, and slight elevation of intravascular
volume.
2. Keeping the MAP higher than the baseline values by about 20 mm/Hg.

Treatment:
It is done by tying the vessels, using a catheter that we insert into the aneurysm, and
we coagulate the vessels, and the treatment is considered successful in 90 percent of
cases.
References:
1. Schwartz TH, Solomon RA. Perimesencephalic nonaneurysmal subarachnoid
hemorrhage: review of the literature. Neurosurgery. 1996 Sep;39(3):433-40;
discussion 440. [PubMed]
2. Kowalski RG, Claassen J, Kreiter KT, Bates JE, Ostapkovich ND, Connolly ES,
Mayer SA. Initial misdiagnosis and outcome after subarachnoid hemorrhage.
JAMA. 2004 Feb 18;291(7):866-9. [PubMed]
3. Gallas S, Tuilier T, Ebrahiminia V, Bartolucci P, Hodel J, Gaston A. Intracranial
aneurysms in sickle cell disease: Aneurysms characteristics and modalities of
endovascular approach to treat these patients. J Neuroradiol. 2020
May;47(3):221-226. [PubMed]