The Resus Room Subarachnoid Haemorrhage; Roadside to Resus
Jun 16, 2021
In this podcast, they discuss the intricate details of subarachnoid hemorrhage, including diagnostic challenges and considerations. They delve into the importance of early intervention and the complexities of using CT scans for detection. They also talk about the significance of rapid sequence intubation for patient care and the challenges in management and treatment for this condition.
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Anatomy and Cause of SAH
- Subarachnoid hemorrhage (SAH) occurs when blood extravasates into the subarachnoid space between the arachnoid and pia mater layers.
- It usually arises from ruptured cerebral aneurysms at arterial bifurcations in the circle of Willis.
SAH Mortality and Diagnostic Challenge
- SAH can be fatal in up to 25% of cases within 24 hours and 50% by three months, with many survivors disabled.
- Despite its seriousness, ED clinicians miss SAH diagnosis in around 5% of cases, making vigilance critical.
Symptom Overlap Challenges Diagnosis
- Symptoms like worst headache ever, neck stiffness, and vomiting overlap significantly between SAH and benign headaches.
- No single clinical sign or symptom reliably rules in or out SAH, complicating diagnosis.