[Clinical evaluation of subarachnoid hemorrhaging]

The classical symptoms of subarachnoid hemorrhaging are acute severe headache, stiff neck, confusion and often vegetative symptoms up to severe cardiac functional disorders. The extent of confusion is variable and correlates with the severity of the disease. Clinical signs are often loss of feeling in cranial nerves which can be indicative not only of the localization of the aneurysm but also of increased brain pressure. Terson's syndrome of vitreous hemorrhaging is indicative of a poor prognosis.Neurological focal symptoms are indicative of intraparenchymal hemorrhage but accompanying cramp attacks often occur independently. Subarachnoid hemorrhaging can present as a transient neurological symptomatic without relevant headache particularly in elderly patients. Despite substantial research activity the prognosis remains as before dependent on the initial clinical symptomatic, as previously described by Hunt and Hess in 1968. Assessment of the severity is nowadays often made in combination with the Glasgow coma scale (GCS).