Incidence and Outcomes of Traumatic Subarachnoid Hemorrhage in Traumatic Brain Injury Patients at a Tertiary Care Hospital

Abstract

Introduction: Traumatic subarachnoid hemorrhage (tSAH) is a frequent intracranial complication of traumatic brain injury (TBI) and is a risk factor for morbidity and mortality. Early recognition is key to appropriate management and better clinical outcomes.

Objective: To estimate the prevalence of traumatic subarachnoid hemorrhage and its clinical outcomes in patients with traumatic brain injury who attend a tertiary care hospital.

Methods: The descriptive cross-sectional study was carried out in the Department of Neurosurgery, Saidu Group of Teaching Hospitals, from November, 2025 to April, 2026. All 196 adult patients who had been diagnosed with TBI on clinical and radiological bases were recruited by non-probability consecutive sampling. Data from the clinical, radiological, and outcome data were analyzed using IBM SPSS Statistics version 27.0.

Results: Fifty-eight (29.6%) patients had traumatic subarachnoid hemorrhage. The study population consisted of 77.0% males, and road traffic accidents were the most predominant cause of injury (54.6%). Patients with tSAH were much more likely to experience adverse outcomes and in-hospital mortality compared to patients without tSAH. Higher age, more severe level of TBI, and the presence of tSAH were significantly correlated with poorer outcomes.

Conclusion: TBI commonly presents with traumatic subarachnoid hemorrhage, and it can be a poor prognosticator. Early diagnosis and timely multidisciplinary management can enhance the prognosis of the patient.