Examination findings in subarachnoid hemorrhage

What are possible physical examination findings in a patient with subarachnoid hemorrhage?

Patients presenting with subarachnoid hemorrhage typically do not demonstrate any localizing signs. They may be lethargic or have meningismus. The exception is in cases of ruptured posterior communicating artery aneurysms. The posterior communicating artery is in close proximity to the third cranial nerve, and ruptured posterior communicating artery aneurysms can cause a third nerve palsy. In these cases the patient typically presents with a painless mydriasis and lateral eye deviation in combination with headache.


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