Health Dictionary
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Subarachnoid hemorrhage clinical prediction rules
Introduction
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Clinical predication rules for diagnosing subarachnoid hemorrhage have been systematically reviewed.[1]
The Ottawa SAH Rule
The Ottawa SAH Rule
The Ottawa SAH Rule[2]
- “For alert patients older than 15 y with new severe nontraumatic headache reaching maximum intensity within 1 hour”
- “Not for patients with new neurologic deficits, previous aneurysms, SAH, brain tumors, or history of recurrent headaches (≥3 episodes over the course of ≥6 months)”
Investigate if ≥1 high-risk variables present:
- Age ≥ 40 years
- Neck pain or stiffness
- Witnessed loss of consciousness
- Onset during exertion
- Thunderclap headache (instantly peaking pain)
- Limited neck flexion on examination
This rule has accuracy of:
- Sensitivity: 100%
- Specificity : 15%
References
References
- ↑ Carpenter CR, Hussain AM, Ward MJ, Zipfel GJ, Fowler S, Pines JM; et al. (2016). “Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Examination, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds”. Acad Emerg Med. 23 (9): 963–1003. doi:10.1111/acem.12984. PMC 5018921. PMID 27306497.
- ↑ Perry JJ, Stiell IG, Sivilotti ML, Bullard MJ, Hohl CM, Sutherland J; et al. (2013). “Clinical decision rules to rule out subarachnoid hemorrhage for acute headache”. JAMA. 310 (12): 1248–55. doi:10.1001/jama.2013.278018. PMID 24065011.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]