Obligatory medical device diagnostics.
- Computed tomography of the skull (cranial CT or cCT) – sensitivity is 95% in the first 24 hours → diagnostic measure of first choice in the acute phase after subarachnoid hemorrhage (SAB).
- If necessary, magnetic resonance imaging of the skull (cranial MRI or cMRI) – for differential diagnosis or in subacute symptomatology.
- For the purpose of localization of the source of hemorrhage or aneurysm visualization:
- Digital subtraction angiography (DSA; procedure for isolated imaging of vessels) – gold standard for detecting cerebral aneurysms as a source of bleeding, as well as the basis for planning closure of the ruptured aneurysm (clipping or coiling?).
- Angiography (imaging of blood vessels by contrast medium in an X-ray examination).
- Transcranial Doppler sonography (ultrasound examination through the intact skull for orienting control of cerebral (“concerning the brain”) blood flow; brain ultrasound) – for early detection of vasospasm; this is one of the determining factors for treatment outcome; it usually occurs within 4 to 14 days (often between the 8th and 12th day) after the subarachnoid hemorrhage
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnosis.
- Electrocardiogram (ECG; recording of myocardial electrical activity) – more than 90% of patients with acute SAB have ECG abnormalities (ischemic signs with ST-segment changes, arrhythmias (cardiac arrhythmias), QT-segment prolongations).
