====== Traumatic subarachnoid hemorrhage (tSAH) ======

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Traumatic [[subarachnoid hemorrhage]] (SAH) is the pathologic presence of blood within the [[subarachnoid space]]s, typically the superficial [[sulci]] along the cerebral convexities
((Witiw CD, Byrne JP, Nassiri F, Badhiwala JH, Nathens AB, da Costa LB. Isolated traumatic subarachnoid hemorrhage: an evaluation of critical care unit admission practices and outcomes from a North American perspective. Crit Care Med. 2018;46(3):430–436. doi:10.1097/CCM.0000000000002931))
((Nassiri F, Badhiwala JH, Witiw CD, et al. The clinical significance of isolated traumatic subarachnoid hemorrhage in mild traumatic brain injury: a meta-analysis. J Trauma Acute Care Surg. 2017;83(4):725–731. doi:10.1097/TA.0000000000001617)).

===== Epidemiology =====

[[Traumatic subarachnoid hemorrhage epidemiology]].



===== Classification =====

[[Traumatic subarachnoid hemorrhage classification]].


===== Pathology =====

[[Traumatic subarachnoid hemorrhage pathology]].


===== Diagnosis =====
[[Traumatic subarachnoid hemorrhage diagnosis]]

===== Differential diagnosis =====

Helpful features in suggesting that subarachnoid hemorrhage is the result of trauma, rather than the reason for trauma. These features include: 

documented (witnessed) trauma not being preceded by a headache or loss of consciousness or seizure

subarachnoid blood being relatively minor and associated with cerebral contusions

subarachnoid blood located over the convexity of the brain rather than around the circle of Willis or posterior fossa

location of subarachnoid blood deep to scalp hematoma or in a contrecoup distribution
----
Patients with traumatic SAH have increased leukocyte counts on hospital admission, which is an important parameter of severity of injury and an additional marker of neurological outcome in patients with severe head trauma
((Rovlias A, Kotsou S. The blood leukocyte count and
its prognostic significance in severe head injury. Surg
Neurol. 2001;55(4):190–196.)).
----

[[Neutrophil to lymphocyte ratio]] (NLR) and [[Platelet-to-lymphocyte ratio]] results (PLR) and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging
((Ogden M, Bakar B, Karagedik MI, Bulut IU, Cetin C, Aydin G, Kisa U, Ozveren
MF. Analysis of biochemical laboratory values to determine etiology and prognosis
in patients with subarachnoid hemorrhage: a clinical study. Neurol Res. 2019
Feb;41(2):156-167. doi: 10.1080/01616412.2018.1545414. Epub 2018 Nov 10. PubMed
PMID: 30417744.
)).

see [[Neutrophil to lymphocyte ratio for subarachnoid hemorrhage]].


===== Treatment =====

see [[Traumatic subarachnoid hemorrhage treatment]].


===== Outcome =====

[[Traumatic subarachnoid hemorrhage outcome]].

===== Case series =====

[[Traumatic subarachnoid hemorrhage case series]].

===== References =====