Headache and vomiting after dinner.

A 48 years old male came with headache and vomiting after dinner. His blood pressure was 170/90, other vital signs were normal. Glasgow Coma Scale: 15 Laboratory analysis was normal There was surgery due to cranial aneurysmal rupture in his history. And now again, Subarachnoid Hemorrhage caused by aneurysm on the anterior communicating artery appeared in the section of the CT scan seen in the picture.

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Subarachnoid hemorrhage is from increase in blood pressure ,keep eye and give coagulant, vitamin K ,better to consult neurosurgeon
Diffuse SAH with aneurysmal rupture. Look like left MCA aneurysm. Available picture it is difficult to say ACOMA aneurysm. Suggest DSA.Needs Urgent ref to interventional Radiologist / Neurosurgeon for further management.
Subarachnoid hemorrhage ( May be due to rapture of artery ) UNDER present circumstances anxiety or mental stress can cause )
Thanks Dr G Tripathy

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Aneurysm leak. Needs angiography may be spiral coiling
Subarachnoid haemorrhage due to aneurysm
Thanks Dr. Vipin Bihari Jain

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SAH associated with probably Anxiety
May be having inadequate clipping / clip slippage/ second aneurysm / minor sah due to hypertension . please do a DSA and consult neurosurgeon . please also look in to details of previous surgery and previous scans
Another sah or rebleed, with hydrocephalus Dsa and active intervention required
Subarachnoid hemorrhage due to aneurysms rupture Recurrent Needs clipping
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