Non-traumatic subarachnoid haemorrhage (SAH) accounts for 5% of acute headache presentations to the emergency department. The urgency to make a diagnosis when patients have a ‘warning leak’ headache, relates to our opportunity to make the diagnosis early, which if missed and the patient has a rebleed, is associated with about a 50% mortality, with half of survivors having significant morbidity.
The approach has generally been to perform a non-contrast CT brain, which is sensitive in the first 6 hours. If the pre-test probability is high, we can then move to a Lumbar puncture (LP) or CT cerebral angiogram (CTCA).
This cohort study looked at the trends in diagnostic testing for the evaluation of headache in the emergency department.
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Published on: 10/06/2024