Abordaje diagnostico, manejo y complicaciones de la hemorragia subaracnoidea

Abstract

Subarachnoid hemorrhage (SAH) is a serious medical emergency characterized by the presence of blood in the subarachnoid space of the brain, usually due to a ruptured aneurysm. Sudden, intense headache, often described as "the worst headache of my life," is the most important and distinctive sign of this condition, often accompanied by nausea, vomiting, and neck stiffness. The global incidence of SAH is approximately 9 per 100,000 inhabitants per year, with a higher prevalence in women over 55 years of age. Significant risk factors include hypertension, smoking and genetic predisposition. Early diagnosis is based on computed tomography (CT) of the head, which confirms the presence of blood in the subarachnoid space. Treatment of SAH includes surgical interventions, such as aneurysm clipping, and endovascular procedures such as embolization, both aimed at preventing rebleeding, which is a leading cause of early mortality. Management of complications, such as vasospasm and hydrocephalus, is crucial to improve prognosis. Hospital mortality remains high, around 26%, and approximately 50% of survivors suffer some degree of significant morbidity. Despite advances in diagnostic and therapeutic techniques, SAH is still associated with a high mortality and morbidity rate. Continuing medical education and adherence to clinical guidelines are essential to optimize the management of this critical condition.