Brain haemorrhage

Subarachnoid haemorrhage -Collection of blood between the arachnoid and pia mater, can be due to medical aneurysmal rupture or traumatic head injury. SAH is a true medical emergency.

SAH is a devastating form of stroke

Thunderclap headache ( described as worst headache of life )

severe headache that develops within seconds to minutes

max intensity at onset

neck stiffness ( typically about 6 hrs after onset of SAH )

photophobiaFeatures of meningism as blood extends into the IVth ventricle - blood further goes down the spinal cord -irritation of surrounding nerves causes neck pain and stiffness

vomiting , reduced level of consciousness

hemiparesis ( occasional seizures )

coma ( high grade SAH )

Sudden death ( about 10 % of cases of spontaneous SAH )

Rapidly escalating headache

Transient loss of consciousness

High probablity SAH if h/o exertional onset , syncope , vomiting , neck pain & seizures

Patient may inform about a prior severe headache &/or h/o small bleed with resolving symptoms ( in the last month or so - called as sentinel bleed )

Often a preceding h/o bending over , lifting heavy objects or other strenuous activities

SAH is a subtype of stroke , affects otherwise healthy...