Objective: To assess the management of patients with subarachnoid hemorrhage in the intensive care unit of the National Hospital of Niamey (Niger).

Methods: This cross-sectional, analytical study, with retrospective and prospective data collection, was conducted in the intensive care unit of the National Hospital of Niamey from April 1, 2020 to May 31, 2024. All patients diagnosed with subarachnoid hemorrhage, whether traumatic or non-traumatic, were included. The variables studied were epidemiological, diagnostic, therapeutic, and prognostic factors. Data were entered and analyzed using Microsoft 2016 and Sphinx v5 software. The chi-square test was used to compare qualitative variables, with a significance threshold of 5%.

Results: The study included 43 patients out of 1373 patients admitted to the intensive care unit, representing a frequency of 3.13%. Males predominated at 74.41% (n=32), with a sex ratio of 2.91. The mean age was 36.47±3.26 years, with ages ranging from 17 months to 90 years. The time to admission was less than 6 hours for 20 patients (46.51%). In this series, 26 patients (60.46%) came from the emergency department, and 21 patients (48.83%) were admitted in a setting of polytrauma. The mean Glasgow Coma Scale score was 8±3, with scores ranging from 3 to 14. Twenty-six patients (60.46%) had a Glasgow Coma Scale score ≤8 on admission, and 28 patients (65.11%) were classified as grade IV according to the WFNS score. All patients underwent brain CT, and 48.83% (n=21) had a Fisher score of 2. Cerebral CT angiography was performed in 4 patients (9.30%). The cause of bleeding was identified in 86.04% (n=37). Trauma was the cause in 69.76% (n=30). The mortality rate was 65.12% (n=28). The median length of stay in intensive care unit was 5 days, ranging from 6 hours to 91 days.

Conclusion: Subarachnoid hemorrhage remains a serious condition. It is a real diagnostic and therapeutic emergency requiring multidisciplinary management. Prognosis depends on how quickly care is provided and on the extent of bleeding.