SAH-CLINICAL FINDINGS

SUMMARY

1. Patients present with typical sudden, unusually severe headaches = thunderclap headache. This is associated with nausea and vomiting.

2. This is a result of extravasation of blood into the CSF space, ventricles or into the brain parenchyma itself.

3. Sentinel haemorrhage may occur in up to 30-60% of patients. This clears within a day.

4. Warning headaches may be due to enlargement of the aneurysm or bleeding confined to the aneurysm wall.

5. Signs – meningismus, hypertension, focal neurologic deficit, ocular haemorrhage, obtundation, coma.

6. Differential diagnosis – SAH, benign thunderclap headaches/crash migraine, benign orgasmic cephalgia.

7. The clinical status is graded according to the World Federation of Neurosurgeons Scale (WFNS).