Lumbar puncture can be used to diagnose subarachnoid haemorrhage in the setting of a clinically suspected SAH but negative or indeterminant CT / MRI It should be performed >6-12 hours after initial presentation: Allows the presence of xanthochromia to develop Prior...
Diagnosis is made by the appearance of hyperdense blood in the subarachnoid space on non-contrast CT This may be widely distributed or more localised, which helps aid the site of a ruptured aneurysm: Widely Distributed Within the basal cisterns, Sylvian and...
To Determine Diagnosis CT head:Detects the presence of subarachnoid bloodHighly sensitive on day 1 (>95%) but reduced thereafter (50% on day 5) MRI an alternative though not readily available at most centresLP:Detects presence of xanthochromiaShould be performed...
Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Clinical WFNS (World Federation of Neurosurgical Societies) GCS score of 15 without focal deficit GCS score of 13 or 14 without focal deficit GCS score of 13 or 14 with focal deficit GCS score of 7-12 GCS score of 3-6 Clinical...
Symptoms Sudden onset headache (70-80%):'Worst ever' or 'thunderclap' in natureOccipital location is classicSentinel headache in 40%Nausea and vomiting (77%) Signs Fluctuating / loss of consciousness (53%)Signs of meningism (35%):Neck...
