Subarachnoid Haemorrhage

1 Historical Review.- 2 Anatomy of the Cerebral Vessels.- Circle of Willis.- Internal Carotid Artery.- Ophthalmic Artery.- Posterior Communicating Artery.- Anterior Choroidal Artery.- Anterior Cerebral Artery.- Middle Cerebral Artery.- Lenticulostriate Arteries (Thalamostriate Arteries).- Posterior Cerebral Artery.- Vertebrobasilar System.- Venous Anatomy.- 3 Pathophysiology.- Massive or Catastrophic Haemorrhage.- Major Subarachnoid Haemorrhage.- Pathological Changes Associated with Minor Haemorrhage.- Histopathological Features.- Aetiology of Subarachnoid Haemorrhage.- Intracranial Aneurysms.- 4 Clinical Features.- Symptomatology.- Physical Examination.- Warning Signs of Impending Subarachnoid Haemorrhage.- Grading of Severity of Subarachnoid Haemorrhage.- 5 Differential Diagnosis.- Modes of Presentation.- Confirmation of Subarachnoid Haemorrhage.- Aetiology of Subarachnoid Haemorrhage.- Subarachnoid Haemorrhage of Unknown Aetiology.- 6 Computerised Tomography.- Material.- CT Scan Appearances.- Blood in the Subarachnoid Cisterns.- Intracerebral Haematoma.- Intraventricular Haematoma.- Subdural Haematoma.- Low Attenuation Areas.- Hydrocephalus.- Contrast Enhancement.- CT in Multiple Aneurysms.- CT Scan Findings and Patient Grade.- CT Scan Findings and Prognosis.- Accuracy of CT.- CT Scan Findings and Subarachnoid Haemorrhage of Unknown Cause.- CT Scan Findings and Vasospasm.- CT and Brain Haemorrhage Due to Intracranial Tumours.- CT and Giant Aneurysms.- CT and Patient Deterioration.- 7 Cerebral Angiography.- Indications.- Contraindications.- Timing.- Technique.- Anterior Cerebral Artery Aneurysms.- Middle Cerebral Artery Aneurysms.- Posterior Communicating Artery Aneurysms.- Internal Carotid Artery (Bifurcation) Aneurysms.- Anterior Choroidal Aneurysms.- Carotid Ophthalmic Aneurysms.- Intracavernous Aneurysms.- Vertebrobasilar Aneurysms.- Angiotomography and Magnification Angiography.- Angiographic Findings in Ruptured Aneurysms.- Accuracy of Angiography.- Peroperative Angiography.- Postoperative Check Angiography.- Complications.- Arteriovenous Malformations.- Mycotic Aneurysms.- Traumatic Aneurysms.- Neoplastic Aneurysms.- Arterial Anomalies.- Fibromuscular Hyperplasia.- Moya Moya Syndrome.- Cerebral Arteritis.- Digital Subtraction Angiography.- 8 Management of Subarachnoid Haemorrhage.- Management at the Receiving Hospital.- General Measures.- Management of the Comatose Patient.- Prevention of Recurrent Haemorrhage.- Treatment of Complications.- Metabolic, Electrolyte and Haematological Changes.- 9 Anaesthesia.- Historical Background.- Pre-operative Management.- Anaesthesia for Angiography.- Anaesthesia for Craniotomy.- Techniques for Special Aneurysms.- Postoperative Management.- Arteriovenous Malformations.- 10 Basic Principles of Surgical Treatment of Intracranial Aneurysms.- Selection of Patients.- Timing of Surgery.- Methods of Surgical Treatment.- Technical Aids for Intracranial Surgery.- Aneurysms in Various Sites.- 11 Results of Surgical Treatment of Intracranial Aneurysms.- Natural History of Intracranial Aneurysms.- Clinical Profile of Surgical Patients.- Outcome.- Analysis of Patients with Fatal Outcome.- Outcome in Relation to the Site of the Aneurysm.- Quality of Survival.- Factors WhichInfluence Outcome.- Conclusions.- 12 Vasospasm.- Cerebral Blood Flow.- Cerebral Autoregulation.- Cerebral Blood Flow in Subarachnoid Haemorrhage.- Aetiology and Pathophysiology.- Pathological Changes in Vasospasm.- Incidence.- Vasospasm and Neurological Condition of the Patient.- Management of Cerebral Vasospasm.- 13 Arteriovenous Malformations.- Incidence.- Natural History.- Pathology.- Surgical Pathology.- Site of the Lesion.- Clinical Presentation.- Management.- Principles of Direct Surgical Treatment.- Operative Procedures.- Postoperative Care.- Alternative Methods of Treatment.- Aneurysms of the Vein of Galen.- 14 Subarachnoid Haemorrhage in Pregnancy.- Incidence.- Cause.- Time of Occurrence.- Course of Haemorrhage.- Physiological Changes During Pregnancy Relevant to Subarachnoid Haemorrhage.- Diagnosis.- Treatment.- 15 Subarachnoid Haemorrhage in Infancy, Childhood and Adolescence.- Material.- Cause.- Aneurysms.- Arteriovenous Malformations.- Idiopathic (No Cause) Group.- Rare Causes.- Neonatal Intracranial Haemorrhage.- 16 Spinal Subarachnoid Haemorrhage.- Aetiology.- Clinical Features.- Differential Diagnosis.- Investigations.- Natural History and Outcome.- Management of Spinal Arteriovenous Malformations.- 17 Future Developments.- Prevention of Subarachnoid Haemorrhage.- Improved Diagnosis.- Treatment of the Complications of Subarachnoid Haemorrhage.- Improved Surgical Techniques.- New Imaging Techniques.