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FMGE 2011 — Radiology

Q: What is the investigation of choice for diagnosing subarachnoid hemorrhage (SAH)?

CT scan. ***CT scan*** - A **non-contrast CT scan of the head** is the immediate investigation of choice for diagnosing SAH due to its high sensitivity for detecting fresh blood. - It can quickly identify the presence of **blood in the subarachnoid space**, especially within the first 6-12 hours after symptom onset. *Radionuclide scan* - This imaging technique uses **radioactive tracers** to evaluate organ function or blood flow. - It is **not used for acute diagnosis** of SAH, as it does not directly visualize blood in the CNS. *X-ray skull* - An **X-ray of the skull** primarily visualizes bone structures and can detect fractures or other bony abnormalities. - It is **ineffective at detecting blood** in the subarachnoid space and is not used for SAH diagnosis. *MRI* - While MRI can detect SAH, especially in subacute or chronic phases, it is **less sensitive than CT for acute SAH** due to longer acquisition times and motion artifacts. - It is often considered if CT is negative and clinical suspicion remains high, but **not as the initial investigation of choice** in an acute setting. [Practice more Radiology PYQs on OnCourse]

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What is the investigation of choice for diagnosing subarachnoid hemorrhage (SAH)?