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CLINICAL FINDINGS IN SAH

Neurosurgery

CLINICAL FINDINGS IN SAH

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).


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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