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Ottawa Subarachnoid Hemorrhage (SAH) Rule
Sep 25, 2013
•
Mark Morgan
categories:
Neurology
Ottawa Subarachnoid Hemorrhage (SAH) Rule
Rule Inclusion Criteria
yes
NO
<-- Age 15 years or over
yes
NO
<-- New, severe nontraumatic headache
yes
NO
<-- Headache reached maximum intensity within 1 hour
no
YES
<-- Neurologic deficits
no
YES
<-- Previous aneurysms
no
YES
<-- History of recurrent headaches (3 or more episodes in the last 6 or more months)
High Risk Variables
no
YES
<-- Age 40 years or over
no
YES
<-- Neck pain or stiffness
no
YES
<-- Witnessed loss of consciousness
no
YES
<-- Onset during exertion
no
YES
<-- Thunderclap headache (instantly peaking pain)
no
YES
<-- Limited neck flexion on examination
Interpretation -->
Interpretation
score=(QA)+(QB)+(QC)+(QD)+(QE)+(QF)+(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6);score>9?'Does not meet rule inclusion criteria. Ottawa SAH Rule may not be used.':score>0?'Meets Inclusion Criteria AND Has High Risk Variables. Further investigation for Subarachnoid Hemorrhage is recommended per Ottawa SAH Rule':'Meets Inclusion Criteria AND Has No High Risk Variables. Further investigation for Subarachnoid Hemorrhage may not be necessary.'
display/hide references
reference:
#1
Perry JJ, Stiell IG, Sivilotti MA, et al. Clinical Decision Rules to Rule Out Subarachnoid Hemorrhage for Acute Headache. JAMA. 2013;310(12):1248-1255.
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