Background: Subarachnoid hemorrhage (SAH) is a life-threatening cerebrovascular event with high morbidity and mortality. Early brain edema is a key determinant of prognosis and can be quantified using the Subarachnoid Hemorrhage Early Brain Edema Score (SEBES). Although SEBES has demonstrated prognostic value in spontaneous SAH, its utility in traumatic SAH remains underexplored. This study aimed to evaluate the relationship between SEBES and clinical outcomes in both traumatic and non-traumatic SAH patients.

Methods: In this retrospective cohort study, 50 SAH patients (30 traumatic, 20 non-traumatic) admitted to the intensive care unit (ICU) between January 2023 and May 2024 were analyzed. SEBES scores were calculated from brain CT scans obtained within 24 hours of SAH onset. Patients were classified by etiology and SEBES grade (≤2 vs. >2). Demographic data, clinical scores, laboratory parameters, and mortality at 1 and 3 months were compared. A subgroup analysis was performed to assess SEBES-associated outcomes within each SAH etiology.

Results: SEBES scores were markedly higher in non-traumatic SAH patients. Higher SEBES (>2) was associated with lower admission and discharge neurological scores (GCS, FOUR), longer ICU and ventilator duration, and higher 1- and 3-month mortality (all p < 0.05). Subgroup analysis revealed that the negative prognostic impact of elevated SEBES was evident in both traumatic and non-traumatic SAH groups, particularly regarding mortality and ICU burden.

Conclusion: SEBES is a valuable and simple radiological prognostic tool applicable to both traumatic and non-traumatic SAH. A SEBES score >2 may predict worse neurological outcomes, higher mortality, and increased ICU resource utilization. Its early application may aid in risk stratification and critical care planning.

Keywords: Subarachnoid Hemorrhage, Early Brain Edema Score, Prognosis, SEBES, Traumatic SAH, Non-Traumatic SAH, Neurocritical Care