Subarachnoid Hemorrhage


4.3 out of 5 (3 Reviews)



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Expiration Date

9 Aug 2022

Last Reviewed

9 Aug 2021

Estimated Time To Finish

120 Minutes

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Activity Description

Subarachnoid hemorrhages are life-threatening and result from the accumulation of blood between the arachnoid and pia mater. The incidence of subarachnoid hemorrhage in the United States is between 10 to 14 out of 100,000 individuals per year. Although presentations may vary, the characteristic presenting symptom is the thunderclap headache, which patients may describe as the “worst headache of my life.” This should prompt further imaging. The headache often is associated with nausea, vomiting, and diplopia. Quite often signs of meningismus are present due to the spread of blood into the fourth ventricle and further down the spinal cord, irritating nerves and causing neck and back pain. Cranial nerve deficits can occur. Practitioners should perform a detailed exam. The presence of focal deficit increases the grade of subarachnoid hemorrhage and changes the perspective of post-event recovery. Patients with a high-grade subarachnoid hemorrhage quite often present in a state of coma that calls for a quick evaluation and urgent treatment, as the coma can be reversible. In addition to subarachnoid hemorrhage patients may have a concurrent intraocular hemorrhage, known as Terson syndrome. When Terson syndrome is present, an ophthalmology service should be consulted to help with the care of the patient. Eighty percent of patients that develop Terson syndrome require regular follow up visits but do not require further intervention. This activity reviews the evaluation and management of subarachnoid hemorrhages and highlights the essential role of the interprofessional team in caring for those with this grave condition.

Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Explain when subarachnoid hemorrhage should be considered on differential diagnosis.
  • Review the exam findings expected in a patient with a subarachnoid hemorrhage.
  • Describe the management of a subarachnoid hemorrhage.
  • Explain the significance of cooperation between the interprofessional team members to enhance the delivery of care for those with subarachnoid hemorrhage.

Author(s) / Contributors Disclosure of Conflicts of Interest

Each author, editor, faculty and planning committee member have completed a disclosure form indicating that neither they nor their spouse/partner has a financial interest/arrangement or affiliation that could be perceived as a real or apparent conflict of interest related to the content of this activity.

COMMERCIAL SUPPORT: This activity has received NO commercial support.

Continuing Education Accreditation Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Quillen College of Medicine, East Tennessee State University, and StatPearls, LLC. The Quillen College of Medicine, East Tennessee State University is accredited by the ACCME to provide continuing medical education for physicians.

Quillen College of Medicine, East Tennessee State University designates this activity for a maximum of 2.00 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation survey. 
  7. Obtain a certificate.

StatPearls and ETSU adhere to ACCME Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and ETSU that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved, and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

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Media Usage Rights

The contributors and editors of StatPearls have attested that all associated media (images and video) have been legally cleared for use with this activity.  All copyrights are reserved.

  • Name: 'SAH.jpg' Attribution: Contributed by Scott Dulebohn, MD
  • Name: 'Stroke_hemorrhagic.jpg' Attribution: Contributed by National Heart Lung and Blood Institute (NIH)
  • Name: 'CT-image-of-subarachnoid-haemorrhage-Non-contrast-CT-scan-of-brain-showing-subarachnoid.png' Attribution: Contributed from Liam Flynn and Peter JD Andrews (CC By S.A. 4.0


Susana C. on 4/27/2021

The narrative material was short and offered little in the way of more complicated management (coiling vs. clipping and when, etc.)

Lars P. on 9/18/2021

John L. on 10/4/2021

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