This is a flowchart on subarachnoid hemorrhage, a type of hemorrhagic stroke, covering the etiology, pathophysiology, and manifestations.
ADDITIONAL TAGS:
Risk factors / SDOH
Cell / tissue damage
Structural factors
Subarachnoid hemorrhage
Medicine / drugs
Infectious / microbial
Biochem / molecular bio
Immunology / inflammation
Signs / symptoms
Tests / imaging / labs
Metabolic / hormonal
Genetics / hereditary
Flow physiology
Pathophysiology
Etiology
Manifestations
Mechanical force transmitted to the brain → trauma (traumatic SAH)
Triggers:
Caffeine consumption
Acute ↑ in blood pressure
Fit of anger
Physical exertion
Hypertension
Risk factors:
Rupture of …
Subarachnoid hemorrhage: bleeding into the subarachnoid space
Intracranial aneurysm, usually berry aneurysms (80%), commonly in the circle of Willis, especially anterior circulation
Arteriovenous malformation
Intracerebral hemorrhage
Smoking
High alcohol consumption
Positive family history
Methamphetamines, cocaine
Large aneurysms
Angioma
Neoplasm
Cortical thrombosis
Infection
Nonspontaneous
Spontaneous
Other causes:
Asymptomatic
Mild headache
+/- nuchal rigidity
Moderate to severe headache
Nuchal rigidity
+/- cranial nerve palsy
Confusion
Lethargy
Mild focal neurologic deficit
Stupor
Hemiparesis
+/- early decerebrate rigidity
+/- vegetative disturbance
Profound coma
Decerebrate posturing
Hunt-Hess classification grade:
II
III
IV
V
Thunderclap headache: severe, sudden, "worst headache of my life," holocephalic, radiates to neck and back
Breakdown of blood products in CNS
Meningeal irritation → meningeal signs
Photophobia
Nausea, vomiting
Kernig, Brudzinski signs
Mass effect
Blood irritates brain parenchyma
Seizures
Low grade, sentinel, "warning" leak of blood
Prodromal symptoms days/weeks before SAH
Transient diplopia
Head CT w/o contrast: hyperdensity (blood) in subarachnoid space (in cerebral sulci) → then +/- CTA, +/- LP
Негізгі бет Subarachnoid hemorrhage (mechanism of disease)
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