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Traumatic Subarachnoid Hemorrhage: A Scoping Review.
Dylan P Griswold1,2,3, Laura Fernandez4, Andres M Rubiano1,4,5
1NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.
Journal of Neurotrauma
|February 27, 2021
Summary
Traumatic subarachnoid hemorrhage (TSAH) is common after traumatic brain injury (TBI). Patients with TSAH from mild TBI often require conservative management, with specific scoring systems aiding outcome prediction.
Area of Science:
- Neuroscience
- Trauma Surgery
- Radiology
Background:
- Traumatic brain injury (TBI) affects 69 million annually, with traumatic subarachnoid hemorrhage (TSAH) being a common consequence.
- TSAH is recognized as a negative prognostic indicator, associated with increased neurological deterioration, morbidity, and mortality.
- Limited research exists on current diagnostic and management trends for TSAH.
Purpose of the Study:
- To conduct a scoping review to determine the scope and nature of evidence regarding diagnostic criteria and management of TSAH.
- To identify gaps in the literature concerning TSAH in trauma patients.
Main Methods:
- A scoping review was performed following the Joanna Briggs Institute methodology.
- Included studies focused on adult patients with SAH secondary to trauma.
- Data extraction covered study aims, methodology, population, outcomes, findings, and future research directions.
Main Results:
- Thirty studies met the inclusion criteria, categorized into TSAH with mild TBI (13 studies), severe TBI (3 studies), clinical management/diagnosis (9 studies), imaging (3 studies), and aneurysmal TSAH (1 study).
- The majority of studies originated from high-income countries.
- Patients with TSAH associated with mild TBI exhibit a low risk of deterioration and surgical intervention, suggesting conservative management and ICU admission consideration.
Conclusions:
- The Helsinki and Stockholm CT scoring systems, AIS, creatinine levels, and age decision trees may aid in predicting outcomes and mortality in TSAH patients.
- Further research is needed, particularly from low- and middle-income countries, to comprehensively understand TSAH diagnosis and management.
