Summary
Definition
História e exame físico
Principais fatores diagnósticos
- headache
- photophobia
- loss of consciousness
- third cranial nerve palsy
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
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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CT head
- CBC
- clotting profile
- serum electrolytes
- troponin I
- serum glucose
- ECG
Investigações a serem consideradas
- lumbar puncture (LP)
- digital subtraction angiography (DSA)
- computed tomography angiography (CTA)
- magnetic resonance angiography (MRA)
Algoritmo de tratamento
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.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
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.
Diferenciales
- Nonaneurysmal perimesencephalic subarachnoid hemorrhage
- Arterial dissection
- Cerebral and cervical arteriovenous malformation (AVM)
Más DiferencialesGuías de práctica clínica
- 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage
- Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage
Más Guías de práctica clínicaVideos
Diagnostic lumbar puncture in adults: animated demonstration
Tracheal intubation: animated demonstration
Más vídeosFolletos para el paciente
Subarachnoid hemorrhage
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