Subarachnoid Hemorrhage: Current Overview

Subarachnoid hemorrhage is a devastating condition due to many etiologies, accounting for 5% of all stroke patients. Rupture of an intracranial aneurysms is most frequent causative factor. The diagnosis is usually easy as clinical symptomatology is quite classical, but diagnosis of warning leaks requires increased degree of suspicion. Non contrast computerised scan (CT) of head is initial investigation of choice, followed by cerebrospinal fluid (CSF) examination if required. Conventional cerebral angiography or 4 vessel intra arterial digital subtraction angiography (DSA) is performed in all cases for aneurysm and cerebral vasculature details. Magnetic resonance angiography (MRA) and CT angiography are increasingly available and popular modes of evaluating aneurysmal bleed but lack the sensitivity of DSA, and are frequently insufficient for surgical planning. The current trend is towards early clipping or coiling of an aneurism, choice depending on aneurysm characteristics, associated features, and centre‟s experience. This review discusses current knowledge about subarachnoid hemorrhage due to aneurysmal bleed