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Abstract

Background: Aneurysm subarachnoid haemorrhage (SAH) is a leading cause of mortality (40% -50% of SAH), occurring in about 10 per 100,000 persons annually; 30, 000 SAH in the United States alone each year. SAH is characterized by three commonly occurring complaints: 'worst headache of my life', photophobia and meningismus. These symptoms often can be confused with bacterial and viral meningitis and migraine headaches. As a result, aneurysm SAH is initially misdiagnosed in nearly 12% of patients, a potentially lethal mistake. The rule of third dictates that one-third of the patients with SAH die before reaching the hospital, another third present with irrecoverable neurological deficits and last third make it to the treatment; half of the last third will have long term disabilities. In short, only about 16% of the patients will be left with the minimal or no permanent neurological sequelae after SAH. A high suspicion for SAH during the initial evaluation in the Emergency Department or by the Primary Care Physician increases the patient's chance for early intervention and reduces mortality and disabilityIt is imperative that emergency department and primary care physicians understand how to diagnose and initially manage aneurysm SAH.Methodology: This study included 30 patients and was conducted in SKIMS Srinagar with aneurysmal SAH who underwent clipping of intracranial aneurysm after taking written informed consent. A detailed history was taken. The age, gender, Glasgow Coma Scale (GCS), World Federation of Neurological Surgeons (WFNS) grade, Hunter and Hess (H -H) grade were recorded after adequate resuscitation and hemodynamic stabilization. Summary and Conclusion:The study included 30 patients with the mean age of 42.7 years. The number of male patients in the study was 17 (56.7%) and the number of female patients was 13 (43.3%). Sudden onset headache was commonest headache occurring in 17 (56.7%) patients followed by altered sensorium with sudden onset headache (43.3%) patients. Patients were mostly in H-H grade 2 (60%) and WFNS grade II (73.3%) with the GCS score of 14-15 (83.3%). H-H grade I-II-grade WFNS I-II and good GCS score translated in better operative outcome and survival where as H-H grade 3-4-5 and bad GCS Score translated in worst outcome.