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  • 8/12/2019 Subarachnoid Hemorrhage Info Dari Wiki


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    Subarachnoid hemorrhage

    Classification and external resources

    CT scan of the brain showing subarachnoid hemorrhage as a white area in the

    center and stretching into the sulci to either side (marked by the arrow)

    ICD-10 I60






    ICD-9 430 (,

    852.0 (



    Subarachnoid hemorrhageFrom Wikipedia,the free encyclopedia

    A subarachnoid hemorrhage (SAH, /sbrknd hm()rd/), or

    subarachnoid haemorrhagein British English, is bleeding into the subarachnoid

    spacethe area between the arachnoid membrane and the pia mater surrounding

    the brain. This may occur spontaneously, usually from a ruptured cerebralaneurysm, or may result from head injury.

    Symptoms of SAH include a severe headache witha rapid onset ("thunderclap

    headache"), vomiting, confusion or a lowered level of consciousness, and

    sometimes seizures.[1]In general, the diagnosisis confirmed with a CT scan of the

    head, or occasionally bylumbar puncture. Treatment is byprompt neurosurgery or

    radiologically guided interventions with medications and other treatments to help

    prevent recurrence of thebleeding and complications. Surgery for aneurysms was

    introduced in the 1930s, but since the 1990s many aneurysms are treated by a less

    invasive procedure called "coiling", which is carried out by instrumentation throughlargeblood vessels.[1]

    SAHis a formof stroke and comprises 17 percent of all strokes.[2]It is a

    medical emergency and can lead to death or severe disabilityevenwhen

    recognized and treated at an early stage. Up to half of all cases of SAH are fatal

    and 1015 percent of casualties die before reaching a hospital,[1]and those who

    survive often have neurological or cognitive impairment.[3]


    1 Signs and symptoms

    2 Causes

    3 Diagnosis

    3.1 Imaging

    3.2 Lumbar puncture
  • 8/12/2019 Subarachnoid Hemorrhage Info Dari Wiki


    3/17/2014 Subarachnoid hemorrhage - Wikipedia, the free encyclopedia 2/18

    OMIM 105800 (

    DiseasesDB 12602 (

    MedlinePlus 000701


    eMedicine med/2883 (

    neuro/357 (

    emerg/559 (

    MeSH D013345 (


    3.3 Angiography

    3.4 ECG

    3.5 Classification

    4 Screening and prevention

    5 Treatment

    5.1 Prevention of rebleeding

    5.2 Vasospasm

    5.3 Other complications6 Prognosis

    6.1 Early morbidity and mortality

    6.2 Long-term outcomes

    7 Epidemiology

    8 History

    9 References

    10 External links

    Signs and symptoms

    The classic symptom of subarachnoid hemorrhage is thunderclap headache (a headache described as "like being kicked in the head", [4]or the "worst ever",

    developing over seconds to minutes). This headache often pulsates towards the occiput (the back of the head).[5]About one-third of people have no symptoms

    apart from the characteristic headache, and about one in ten people who seek medical care with this symptom are later diagnosed with a subarachnoid

    hemorrhage.[1]Vomiting may be present, and 1 in 14 have seizures. [1]Confusion, decreased level of consciousness or coma may be present, as may neck stiffness

    and other signs of meningism.[1]Neck stiffness usually presents six hours after initial onset of SAH. [6]Isolated dilation of a pupil and loss of the pupillary light reflex

    may reflect brain herniation as a result of rising intracranial pressure (pressure inside the skull).[1]Intraocular hemorrhage (bleeding into the eyeball) may occur in

    response to the raised pressure: subhyaloid hemorrhage (bleeding under the hyaloid membrane, which envelops the vitreous body of the eye) and vitreoushemorrhage may be visible on fundoscopy. This is known as Terson syndrome (occurring in 313 percent of cases) and is more common in more severe SAH. [7]

    Oculomotor nerve abnormalities (affected eye looking downward and outward and inability to lift the eyelid on the same side) or palsy (loss of movement) may

    indicate bleeding from the posterior communicating artery.[1][5]Seizures are more common if the hemorrhage is from an aneurysm; it is otherwise difficult to predict

    the site and origin of the hemorrhage from the symptoms. [1]SAH in a person known to have seizures is often diagnostic of an arteriovenous malformation.[5]