Der Radiologe
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Despite further improvement of diagnostic procedures and the management of patients with acute subarachnoid hemorrhage it is still a severe clinical condition often worsened by several secondary complications after the initial bleeding. The most important and most frequent are early rehemorraging, cerebral vasospasm and the development of hydrocephalus. In addition there are many other sequelae, such as disturbances of electrolytes, seizures and the general complications of intensive care medicine which can greatly influence clinical outcome. This report provides an overview of the possible mechanisms for the development of complications, the typical temporary course and the currently available therapeutic strategies, in particular focused on the role of diagnostic imaging in early detection of these pathological conditions.
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Subarachnoid hemorrhage is characterized by the extravasation of blood into the spaces covering the central nervous system which are filled with cerebrospinal fluid. The leading cause of non-traumatic subarachnoid hemorrhage is rupture of an intracranial aneurysm. ⋯ The characteristic appearance of extravasated blood is hyperdense. Head CT scanning can also demonstrate intraparenchymal hematomas, hydrocephalus and cerebral edema and can help predict the site of aneurysm rupture.