Intracranial aneurysm and subarachnoid haemorrhage (SAH)

Subarachnoid haemorrhage (SAH) should be suspected however slight the symptoms, and the diagnosis confirmed with an urgent CT scan. The patient should be transferred without delay to a neurosurgical unit for cerebral angiography, accompanied by an escort with sufficient skills in emergency medical care. A ruptured intracranial aneurysm must be closed (microsurgical clipping or an endovascular approach) during the acute phase to prevent rebleeding. The patient should be admitted to a neurolointensive care unit at an appropriate hospital with a neurosurgical unit. Rehabilitation is the responsibility of the neurological unit, as is the work capacity assessment. Unruptured aneurysms should be closed to prevent late bleeds. Screening for aneurysm carriers should be performed in known aneurysm families.Health counselling should be provided concerning the most important risk factors: smoking, hypertension, family history of aneurysms.