Professional Documents
Culture Documents
Deni&on
Subarachnoid
haemorrhage
is
dened
as
bleeding
into
the
subarachnoid
space
within
the
intracranial
vault.
Review of anatomy
Incidence
9.1
per
100,000
annually
Risk
increases
in
older
age
-
60%
higher
in
age
above
80
Risk
of
SAH
is
rela&vely
higher
in
women
over
55
years
than
men
Risk
factors
Race
Sex
Age
Gene&cs
Smoking
Alcohol
E&ology
Head
trauma
Intra
cranial
aneurysm
Increased
blood
pressure
Increased
blood
ow
Blood
vessel
disorders
Gene&c
Infec&ous
Types
of
aneurysm
Berry
(saccular)aneurysm
Giant
(fusiform)
aneurysm
Myco&c
aneurysm
Charcot
Bouchard
aneurysm
Trauma&c
aneurysm
Types of aneurysm
Loca<on
Pathophysiology
Mass
eect
Rupture
eect
Rupture
of
cerebral
aneurysm
Bleeding
into
subarachnoid
space
Stroke
syndrome
develops
Increased
ICP
Clinical
features
Symptoms:
Sudden
severe
headache
with
or
without
LOC
Associated
with
vomi&ng,
photophobia,
drowsiness,
restlessness
and
agita&on
Some
&me
-
low
back
pain
and
bilateral
radicular
leg
pain
(Spinal
SAH)
Signs: Neck s&ness Impaired level of consciousness in some pa&ents Subhyaloid haemorrhage (op&c fundus)
Kernigs sign
Brudzinskis sign
Mild altera&on in mental status (confusion, lethargy), mild focal neurological decit Stupor and/or hemi paresis Comatose and/or decerebrate rigidity
Diagnos<c
procedures
Computed
tomography
Lumbar
puncture
Cerebral
angiography
Angiography
Complica<ons
Re-bleeding
Hydrocephalus
Intraventricular
haemorrhage
Increased
intracranial
pressure
Intracerebral
hemorrhage
Seizures
Cerebral
vasospasm
Management
Medical
management:
Acute
care
:
If
pa&ent
is
comatose
-
ven&lator
assistance
ABG
analysis
Emergency
CT
scan
Cardiac
monitoring
Pain
management
The goal of treatment : to prevent re bleeding and cerebral vasospasm Re bleeding Bed rest Recombinant ac&vator factor VII
Coiling of aneurysm
Vasospasm
Respiratory complica&on Venous complica&on Cardiovascular complica&on Fluid and electrolyte disturbance Gastrointes&nal complica&on
Summary
Deni&on
Incidence
Risk
factors
E&ology
Types
Pathophysiology
Clinical
manifesta&on
Management
Complica&on