Subarachnoid hemorrhage

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Last reviewed: 23 Sep 2025
Last updated: 29 Aug 2025

Summary

Definition

História e exame físico

Principais fatores diagnósticos

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

Outros fatores diagnósticos

  • 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
  • seizures
Detalhes completos

Fatores de risco

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

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CT head
  • CBC
  • clotting profile
  • serum electrolytes
  • troponin I
  • serum glucose
  • ECG
Detalhes completos

Investigações a serem consideradas

  • lumbar puncture (LP)
  • digital subtraction angiography (DSA)
  • computed tomography angiography (CTA)
  • magnetic resonance angiography (MRA)
Detalhes completos

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Consultores especialistas

Salah Keyrouz, MD, FAHA, FCCM

Professor

Neurology and Neurosurgery

Washington University School of Medicine

St. Louis

MO

Disclosures

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

Acknowledgements

Dr Salah Keyrouz would like to gratefully acknowledge Dr Michael N. Diringer, a previous contributor to this topic.

Disclosures

MND is an author of a number of references cited in this topic.

Peer reviewers

Venkatesh Aiyagari, MD

Associate Professor

Department of Neurology and Rehabilitation

University of Illinois at Chicago

Chicago

IL

Disclosures

VA declares that he has no competing interests.

Peter Martin, MA, BM BCh, MD, FRCP

Consultant Neurologist

Addenbrookes Hospital

Cambridge

UK

Disclosures

PM declares that he has no competing interests.

Giovanni Grasso, M.D., PhD

Aggregate Professor of Neurosurgery

Neurosurgical Clinic

Department of Clinical Neuroscience

University of Palermo

Palermo

Italy

Divulgaciones

GG declares that he has no competing interests.

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Referencias

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Artículos principales

Thompson BG, Brown RD Jr, Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015 Aug;46(8):2368-400.Texto completo  Resumen

Steiner T, Juvela S, Unterberg A, et al. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis. 2013 Feb 7;35(2):93-112.Texto completo  Resumen

Hoh BL, Ko NU, Amin-Hanjani S, et al. 2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2023 Jul;54(7):e314-70.Texto completo  Resumen

Treggiari MM, Rabinstein AA, Busl KM, et al. Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2023 Aug;39(1):1-28. Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Subarachnoid hemorrhage images
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  • Guías de práctica clínica

    • 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage
    • Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage
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  • Videos

    Diagnostic lumbar puncture in adults: animated demonstration

    Tracheal intubation: animated demonstration

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