[Diagnosis of subarachnoid hemorrhage]

A total of 115 patients with subarachnoid hemorrhage were retrospectively analyzed with the aim to evaluate the timing and reliability of the applied diagnostic procedures. In the group of 63 patients the reliability of CT as the diagnostic procedure was investigated, and CT scan was correlated with the clinical status of the respective patient. In the group of 79 patients with operatively treated cerebral aneurysm the angiographic and intraoperative findings were mutually compared and discrepancies were analyzed.

During the first 48 hours after the hemorrhage, only 35.2% of all the angiographies were performed, so the final diagnosis was late in 64.8% of patients. Hemorrhage was diagnosed by CT in 87.3% of the cases and pronounced correlation existed between CT and the clinical status of the patient. Discrepancies between angiographic and operative findings existed in 16.4% of patients.

CT should be the initial procedure for the diagnosis of subarachnoid hemorrhage. In nonmoribund patients the early angiography should also be performed. The main reason for delaying in diagnosis is the overdue transfer of the patients to the referral hospitals.