Seventy-four patients with proved spontaneous subarachnoid haemorrhage were studied. Sixty-four underwent computed tomography and 55 underwent lumbar puncture. Seven cases deteriorated dramatically after lumbar puncture, six of these showing evidence of cerebral dislocation on further investigation. Four of the seven had not undergone computed tomography and three underwent computed tomography ...

It is well known that cardiopulmonary complications are often associated to subarachnoid haemorrhage. For appropriate therapeutic managing it is very important to distinguish acute coronary syndrome from neurogenic myocardial injury, which is a reversible condition. Furthermore, because the hearts of brain dead patients may be utilized for therapeutic purpose, it has became of importance to rul...

Subarachnoid haemorrhage (SAH) associated with intra-axial tumours is extremely uncommon and is usually seen in association with intratumoural bleed. Tumours located near the ventricle or subarachnoid spaces have a higher propensity for SAH compared to intraparenchymal lesions. Low-grade tumours rarely demonstrate any evidence of bleed on imaging. Oligoastrocytomas of the poster...

Arginine vasopressin was measured in the blood and cerebrospinal fluid (CSF) of 42 patients with subarachnoid haemorrhage. Increased concentrations of vasopressin were present in 10 patients, of whom eight had bled from an anterior communicating artery aneurysm. In three patients high blood vasopressin values were associated with gross hyponatraemia. Five patients were found to have increased C...

Plasma adrenaline and noradrenaline concentrations were measured in 21 patients after subarachnoid haemorrhage and in 13 control patients. Plasma noradrenaline concentrations were significantly raised in patients recovering from subarachnoid haemorrhage, confirming clinical evidence of overactivity of the sympathetic nervous system. Plasma noradrenaline concentrations in patients with a poor re...

Subarachnoid haemorrhage following transection of the posterior artery was produced in 10 baboons. Cerebral blood volume (CBV) decreased transiently after subarachnoid haemorrhage. Two basic patterns of intracranial pressure (ICP) were observed; in one ICP returned to normal but in the other it remained elevated. In this latter group four out of five animals showed an increase in CBV above the ...

CLINICAL QUESTION Is lumbar puncture still needed in suspected subarachnoid hemorrhage with a negative head computed tomographic scan performed within 6 hours of headache onset? ARTICLE CHOSEN Perry JJ, Stiell IG, Sivilotti ML, et al. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011...

Subarachnoid haemorrhage is a known but rare manifestation of cerebral venous and dural sinus thrombosis. We present a case of a 62-year-old female with stable Crohn’s disease, who developed thunderclap headache with nausea. Upon presentation, she had no meningism and her neurological examination was normal. Unenhanced computed tomography (CT) revealed a small subarachnoid haemorrhage in the ri...

The recent publication of the results of the international study on unruptured intracranial aneurysms highlighted a paradox: there do not seem to be enough unruptured aneurysms in the population to account for the observed incidence of subarachnoid haemorrhage. Some authors have suggested that the answer to this paradox is that most aneurysms that bleed do so shortly after formation. This would...

CASE REPORT We present the case of a 48 year-old man who had a sudden onset of vomiting, headache and loss of consciousness. The visual acuity was severely reduced in the left eye, with a large subhyaloid haemorrhage being observed in the fundus. DISCUSSION The combination of subarachnoid haemorrhage and a vitreous haemorrhage is called Terson syndrome. The details of the treatment of this ca...