Subarachnoid hemorrhage: A review

Subarachnoid hemorrhage from the rupture of a saccular aneurysm remains a major neurosurgical problem that affects 25,000 to 28,000 people yearly. Unfortunately, the mortality from this devastating disease process has not changed significantly in the last 30 years. For emergency physicians, the early detection and diagnosis of subarachnoid hemorrhage is critical to the potential of reducing the mortality from such an event. This article reviews and updates the natural history of subarachnoid hemorrhage, its incidence, presentation, diagnosis, and management from the standpoint of the emergency physician. It does not explore all controversial areas in exhaustive depth, but rather summarizes material that is of importance to emergency physicians in their approach to the problem.