Chapter 39 Subarachnoid hemorrhage
Introduction
Subarachnoid hemorrhage (SAH) is defined as bleeding into the subarachnoid space of the brain. The most common etiology of SAH is trauma (Greene 1995, Greene 1996, Taneda 1996, Hanlon 2005). Other etiologies are shown inTable 39.1 and include aneurysmal SAH, perimesencephalic hemorrhage, vertebral artery dissection, and arteriovenous malformations (AVMs) to name a few. Aneurysmal SAH accounts for approximately 85% of all causes of non‐traumatic SAH and will be the focus of this chapter. Perimesencephalic SAH, SAH from vertebral artery dissection and traumatic SAH are briefly reviewed. Isolated spinal SAH is not discussed in this chapter.
Section snippets
Other causes of SAH
Aneurysmal SAH represents 80–85% of all causes of SAH (Rinkel et al., 1993). Perimesencephalic hemorrhage represents 10% and the remaining 5% are caused by various other conditions (Adams 1991, Rinkel 1993) (Table 39.1).
Conclusions
SAH can result from many etiologies. The most frequent overall cause is trauma but aneurysmal SAH accounts for 85% of all non‐traumatic causes. Rapid medical stabilization followed by appropriate investigations and management are important in improving patient outcomes. Diagnostic imaging has improved significantly over the last 15 years but further work is needed. A better understanding and treatment of vasospasm will lead to improved patient outcomes. Finally, patients with SAH are best
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