Last reviewed: 7 Jan 2023
Last updated: 09 Aug 2022
Summary
Definition
History and exam
Key diagnostic factors
- headache
More key diagnostic factors
Other diagnostic factors
- seizures
- nuchal rigidity
- decreased level of consciousness
- focal neurologic deficit
Other diagnostic factors
Risk factors
- smoking
- moderate- to high-level alcohol consumption
- family history of subarachnoid hemorrhage
- previous subarachnoid hemorrhage
- heritable connective tissue disease
- hypertension
- head trauma
- intracranial infection
- tumor
- arteriovenous malformations or fistulas
- drug abuse
More risk factors
Diagnostic investigations
1st investigations to order
- conventional catheter-based angiogram
- CT angiography
- magnetic resonance angiography
More 1st investigations to order
Investigations to consider
- CT head scan
- lumbar puncture
More investigations to consider
Treatment algorithm
ACUTE
unruptured aneurysm
ruptured aneurysm
Contributors
Authors
Giovanni Grasso, MD, PhD
Associate Professor
Department of Clinical Neurosciences
Neurosurgical Unit
University of Palermo
Palermo
Italy
Disclosures
GG declares that he has no competing interests.
Acknowledgements
Dr Grasso would like to gratefully acknowledge Dr Michael Chen, the previous contributor to this topic. MC is an author of a reference cited in this topic.
Peer reviewers
Jae H. Choi, MD
Research Director
Stroke Center/The Neurological Institute
Columbia-Presbyterian Medical Center
New York
NY
Disclosures
JHC 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.
Differentials
- Arteriovenous malformation
- Hypertensive intracerebral hemorrhage
- Cerebral venous sinus thrombosis
More DifferentialsGuidelines
- Guidelines on management of unruptured intracranial aneurysms
- Cerebrovascular diseases - aneurysm, vascular malformation, and subarachnoid hemorrhage
More GuidelinesPatient leaflets
Emergency treatment for a stroke
More Patient leafletsLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer