In the above case which had come to our department with a history of head injury we can observe the hyperdensity of blood density in the subarachnoid spaces within the cisterns, interhemispheric fissure and also along the tentorium cerebelli. These findings are typical of Subarachnoid hemorrhage with some amount of subdural component.
DISCUSSION
Definitions
Blood within subarachnoid spaces between pial & arachnoid membranes
Best imaging tool: CT Scan
NECT Findings :
High density in subarachnoid space(s)/cisterns
Hyperdense blood in interpeduncular cistern
Top Differential Diagnoses
• Non-traumatic SAH (ntSAH)
• Meningitis
• Carcinomatosis
• High inspired oxygen
Clinical Presentation :
• Most common signs/symptoms: Headache, emesis, ~consciousness
• Clinical profile: Trauma is most common cause of SAH, not ruptured aneurysm
• Amount of tSAH on initial CT correlates with delayed ischemia, poor outcome
• Requires supportive therapy
Treatment
• Requires supportive therapy
o Intubation, supplemental oxygen, IV fluids, therapy of altered vital signs
o Sedatives & medications for pain, nausea, & vomiting as needed
o Anticonvulsants for seizures
• Nimodipine, a calcium channel blocker, may prevent vasospasm & its complications
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