Can spontaneous subarachnoid hemorrhage be ruled out by modern-generation computed tomography scanning of the brain within 6 hours of acute headache onset?

BEEM Bottom Line

Why is this study important?

First, this is a frequent clinical question: should I stop investigating or should I continue? If a lumbar puncture (LP) is unnecessary to rule out a spontaneous subarachnoid hemorrhage (SAH) following a negative computer tomography (CT) scan, one would reduce post-LP headaches and traumatic LPs as well as the inconvenience and delays that go with them. However, we need to be aware that we also might miss 2 SAHs per 1,000 patients presenting with acute headache.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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