Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • headache
  • photophobia
  • loss of consciousness
  • third cranial nerve palsy

Other diagnostic factors

  • age >50 years
  • female sex
  • black people
  • nausea/vomiting
  • altered mental status
  • meningismus
  • unilateral or bilateral sixth cranial nerve palsies
  • intraocular hemorrhage
  • focal neurologic deficits

Risk factors

  • hypertension
  • smoking
  • alcohol use
  • cocaine use
  • FHx
  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • pseudoxanthoma elasticum
  • neurofibromatosis type I
  • autosomal dominant polycystic kidney disease (ADPKD)

Diagnostic investigations

1st investigations to order

  • CT head
  • CBC
  • clotting profile
  • serum electrolytes
  • troponin I
  • ECG
Full details

Investigations to consider

  • LP
  • digital subtraction angiography (DSA)
  • computed tomography angiography (CTA)
  • magnetic resonance angiography (MRA)
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Associate Professor

Neurology and Neurosurgery

Washington University School of Medicine

St. Louis

MO

Disclosures

SK is an author of a reference cited in this monograph.

Dr Salah Keyrouz would like to gratefully acknowledge Dr Michael N. Diringer, a previous contributor to this monograph. MND is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Associate Professor

Department of Neurology and Rehabilitation

University of Illinois at Chicago

Chicago

IL

Disclosures

VA declares that he has no competing interests.

Consultant Neurologist

Addenbrookes Hospital

Cambridge

UK

Disclosures

PM declares that he has no competing interests.

Aggregate Professor of Neurosurgery

Neurosurgical Clinic

Department of Clinical Neuroscience

University of Palermo

Palermo

Italy

Disclosures

GG declares that he has no competing interests.

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