Subarachnoid hemorrhage in ten questions

Diagn Interv Imaging. 2015 Jul-Aug;96(7-8):657-66. doi: 10.1016/j.diii.2015.06.003. Epub 2015 Jul 2.

Abstract

Traumatic subarachnoid hemorrhage (SAH) has an annual incidence of 9 per 100 000 people. It is a rare but serious event, with an estimated mortality rate of 40% within the first 48hours. In 85% of cases, it is due to rupture of an intracranial aneurysm. In the early phase, during the first 24hours, cerebral CT, combined with intracranial CT angiography is recommended to make a positive diagnosis of SAH, to identify the cause and to investigate for an intracranial aneurysm. Cerebral MRI may be proposed if the patient's clinical condition allows it. FLAIR imaging is more sensitive than CT to demonstrate a subarachnoid hemorrhage and offers greater degrees of sensitivity for the diagnosis of restricted subarachnoid hemorrhage in cortical sulcus. A lumbar puncture should be performed if these investigations are normal while clinical suspicion is high.

Keywords: CT; Hemorrhage; Intracranial aneurysm; MRI.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aneurysm, Ruptured / diagnosis*
  • Aneurysm, Ruptured / mortality
  • Artifacts
  • Cerebral Angiography
  • Contrast Media
  • Diagnosis, Differential
  • Emergencies*
  • Humans
  • Hydrocephalus / diagnosis
  • Hydrocephalus / mortality
  • Image Enhancement
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurologic Examination
  • Sensitivity and Specificity
  • Spinal Puncture
  • Subarachnoid Hemorrhage / diagnosis*
  • Subarachnoid Hemorrhage / mortality
  • Subarachnoid Hemorrhage, Traumatic / diagnosis*
  • Subarachnoid Hemorrhage, Traumatic / mortality
  • Tomography, X-Ray Computed

Substances

  • Contrast Media