Akademik Veri Yönetim Sistemi
World Academic Congress of Emergency Medicine 2023, Antalya, Türkiye, 28 - 31 Ekim 2023, ss.808-809, (Özet Bildiri)
Introduction and Purpose: Non-traumatic subarachnoid hemorrhage (SAH) is most commonly caused by ruptured saccular aneurysms. SAH is often a devastating event with significant mortality and high morbidity among survivors.
Materials and Methods: A 75-year-old male patient was brought to us by the 112 teams with a sudden onset of clouding of consciousness. He have a known diagnosis of COPD. Oncoming GCS 3, blood pressure: 215/125 mmHg saturation 82% (with 2 lt/min oxygen) heart rate was 76/min. The patient was intubated by our team. There were subarachnoid hemorrhage and aneurysm in the left MCA in the brain tomography and brain angiography. He was consulted to Neurosurgery. Cardiac arrest developed during the consultation. The patient was resuscitated for 45 minutes. The patient, whose pulse and blood pressure could not be detected, was evaluated as exitus.
Results and Conclusion: Headache due to non-traumatic subarachnoid haemorrhage is a sudden very severe headache that typically peaks within seconds or minutes. SAH is a neurointerventional emergency and all patients presenting with acute thunderclap headache should be evaluated for SAH. Non-contrast cranial CT should be the first diagnostic test. While the sensitivity of CT is quite high in the early post-bleeding period, it decreases over time. Sentinel headache is an important warning sign, but it can still be missed in emergency services. CT or MR angiography is sometimes performed in patients presenting to the emergency department with thunderclap headache, however, these examinations do not only reveal the etiology of SAH, but are also helpful in the differential diagnosis of thunderclap headache. Early diagnosis and treatment are important for the prevention of complications such as rebleeding and vasospasm.