ABSTRACT
This chapter presents a case study of a 45-year-old female who is presented to the Emergency Department with confusion. According to her partner, she was complaining of a severe headache when she started vomiting and became less coherent in her speech. The non-contrast computed tomography brain shows hyperdensity in the basal cisterns extending into the sylvian fissure and posteriorly into the ambient cisterns, consistent with subarachnoid haemorrhage (SAH). Given that a diagnosis of SAH has been obtained, there is little additional value in performing a lumbar puncture (LP). After a diagnosis of SAH is obtained, the next step in consultation with neurosurgery would be to identify the source of the SAH and other unruptured aneurysms or arteriovenous malformations (AVMs). A common early sequela of SAH is hydrocephalus, especially in the setting of intraventricular haemorrhage, causing cerebrospinal fluid (CSF) outflow/resorption obstruction.
