Subarachnoid Haemorrhage
MC cause: Rupture of berry aneurysm
Presentation
• Sudden severe "Thunderclap" headache (worst headache of life)
• Neck stiffness / pain
Risk Factors
• Hypertension
• Smoking
• Polycystic kidney disease (↑ risk of berry aneurysm)
Investigation
• CT head (first line) → hyperdense blood in basal cisterns
• Cerebral angiography (gold standard)
• If CT normal → Lumbar puncture after 12 hrs → xanthochromia
Treatment
• Nimodipine to prevent cerebral vasospasm
• Endovascular coiling / clipping
Presentation
• Sudden severe "Thunderclap" headache (worst headache of life)
• Neck stiffness / pain
Risk Factors
• Hypertension
• Smoking
• Polycystic kidney disease (↑ risk of berry aneurysm)
Investigation
• CT head (first line) → hyperdense blood in basal cisterns
• Cerebral angiography (gold standard)
• If CT normal → Lumbar puncture after 12 hrs → xanthochromia
Treatment
• Nimodipine to prevent cerebral vasospasm
• Endovascular coiling / clipping
Notes:
Think of sudden worst-ever headache + neck stiffness. Always rule out SAH before LP. Nimodipine is exam favorite.
Paracetamol Overdose Flashcard
Think of sudden worst-ever headache + neck stiffness. Always rule out SAH before LP. Nimodipine is exam favorite.
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