Subarachnoid haemorrhage (SAH) due to a ruptured cerebral aneurysm is a potentially fatal condition that
presents as headache. A raised index of suspicion must exist for all patients with sudden, severe headache with or
without associated symptoms. Initial investigation of suspected SAH should be a
noncontrast CT scan. Management of SAH is increasingly becoming endovascular. The outcome for patients with
no or only a mild global or focal neurological deficit on presentation has improved, but pre-hospital mortality and
disability from the initial haemorrhage remains a problem. Unruptured asymptomatic aneurysms are not an urgent
scenario and can be dealt with in consultative outpatient fashion.
Modern Medicine – March 2018