Traumatic subarachnoid hemorrhage diagnosis

It has been reported that patients with traumatic subarachnoid hemorrhage 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 traumatic brain injury ¹⁾.

Traumatic subarachnoid hemorrhage, often a small amount of blood is seen filling a few sulci, sometimes with an adjacent cerebral contusion. Small amounts of blood can also sometimes be appreciated pooling in the interpeduncular fossa, appearing as a small hyperdense triangle, or within the occipital horns of the lateral ventricles.

Occasionally, and worrying for an underlying arterial dissection or an aneurysmal hemorrhage that preceded trauma, larger amounts of blood may be seen around the Circle of Willis and within the posterior fossa.

When the history of trauma is not clear, an arteriogram may be indicated to R/O a ruptured aneurysm (possibly precipitating the trauma).