Traumatic basal subarachnoid haemorrhage

Traumatic basal subarachnoid haemorrhage (TBSAH) refers to a severe centred bleed, almost invariably resulting from micro-tear or in exceptional circumstances more lengthy dissection of the intracranial vertebrobasilar arterial system. This is typically caused by an impact side upper neck, angle jaw and/or ear/mastoid region. TBSAH associated with immediate comatose state, often accompanied intervention cardiorespiratory arrest. Delayed presentations are rare but do occur and may be related dissections traumatic false aneurysms. The forensic approach cases suspected can very rewarding exercise if carried out due diligence technique as this yield evidence informative on (i) any predisposing vasculopathy enhancing susceptibility tearing, (ii) whether undue force was implicated (iii) incontrovertible, pathognomonic mechanical basis rupture confirming overstretching vessel, thus ruling natural disease such berry aneurysm. main focus presentation will discuss optimum techniques addressing these issues. Whilst source intracranial, best practice includes examination extracranial vertebral arteries which does not need onerous task.