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Traumatic Intracranial Subarachnoid Hemorrhage
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Traumatic Intracranial Subarachnoid Hemorrhage
, Traumatic Subarachnoid Hemorrhage, Traumatic SAH
See Also
Subarachnoid Hemorrhage
Cerebral Aneurysm
Neurovascular Anatomy
Epidural Hematoma
Subdural Hematoma
Intracerebral Hemorrhage
Head Injury
Cerebrovascular Accident
Increased Intracranial Pressure in Closed Head Injury
Background
See
Subarachnoid Hemorrhage
This page refers only to Traumatic Subarachnoid Hemorrhage (non-aneurysmal)
Mechanism
See
Head Injury
Fall with
Head Injury
in the elderly
Motor Vehicle Accident
in younger patients
Imaging
See
Subarachnoid Hemorrhage
Management
Gene
ral
See
Subarachnoid Hemorrhage
Management
Small Traumatic Subarachnoid Hemorrhage
Background
Small Traumatic Subarachnoid Hemorrhage (SAH) is a common finding on
CT Head
after
Closed Head Injury
Unlike
Aneurysmal SAH
, small Traumatic SAH is much less likely to have neurologic decompensation
Cerebral
Vasocon
striction is much less likely in Traumatic SAH (contrast with
Aneurysmal SAH
)
Monitoring
Serial
Neurologic Exam
s
Repeat
CT Head
in 6 hours after first imaging
CT Head
Indicated for early discharge or as needed for
Neurologic Exam
changes on exam
Indications to consider early discharge after repeat
Head CT
(at 6 hours)
Glasgow Coma Scale
(GCS) 15
No
Anticoagulation
or antiplatelet agents
Safe home social situation (e.g. not homeless, available for close interval follow-up)
Small peripheral
Subarachnoid Hemorrhage
consistent with Traumatic SAH
Central SAH is much more suggestive of
Aneurysmal SAH
References
Marcolini and Swaminathan in Swadron (2023) EM:Rap 23(5): 13-4
References
Swaminathan and Marcolini in Herbert (2017) EM:Rap 17(6):17-18
Burgess and Stowens (2014) Crit Dec Emerg Med 28(5): 2-13
Levy (2015) Crit Dec Emerg Med 29(4): 10-4
Bederson (2009) Stroke 40(3): 994-1025 [PubMed]
Cohen-Gadol (2013) Am Fam Physician 88(7): 451-6 [PubMed]
van Gijn (2007) Lancet 369(9558): 306-18 [PubMed]
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