Other Diagnostic Strategies

Table 2: Other diagnostic strategies
Primary CT angiography (CTA)

Some have suggested use of CTA as the initial investigation [75]. However, it does not lead to an improvement in the diagnostic yield of SAH over standard work up [75].

Primary MR angiography (MRA)

Detection of acute SAH by MRA has a sensitivity of 94% within 4 days. Sensitivity may increase as time passes making this a useful tool for the investigation of patients with a delayed (>2 weeks) presentation [75].

Lumbar puncture first

An LP first strategy has been postulated in patients with and no clinical evidence of raised intracranial pressure [76]. However, CT first may point to SAH or another significant diagnosis without recourse to an invasive LP.