Decompressive Craniectomy: can be prophylactic or therapeutic; increases intracranial compliance and prevents/treats elevated ICP (especially if dura opened)
Monitoring in the critically ill subarachnoid haemorrhage patient is primarily to detect vasospasm.
Neurosurgery Literature Summaries
SAH Complications including Neurological deterioration; Seizures; Hyponatremia; Cardiac complications; Re-bleeding; Vasospasm
Subarachnoid Haemorrhage Grading Systems: GCS; Hunt and Hess; WFNS; Fisher; Claassen; Ogilvy and Carter
SAH ICU Management: Follows initial management of SAH; FASTS HUGS IN BED Please applies; certain aspects have particular relevance
SAH initial management includes: resuscitation; specific treatment; supportive care and monitoring; disposition
Subarachnoid Haemorrhage (SAH) potentially fatal bleeding into the subarachnoid space, usually due to a ruptured cerebral aneurysm
Subarachnoid Haemorrhage: Prognostication - some factors are modifiable; mortality rates currently ~35%; 15% die prior to reaching hospital; 8-20% long-term dependence
Vasospasm in SAH: vasospasm = dynamic narrowing of vessels due to a radiological diagnosis; delayed neurological deterioration (DND) is clinically detected neurological deterioration after stabilisation not due to re-bleeding, may be due to multiple other causes; delayed cerebral ischaemia (DCI) is any neurological deterioration >1 hour that presumed due to ischemia, and other causes excluded
Bacterial ventriculitis (BV) is inflammation of the ventricular drainage system, usually due to bacterial infection of the cerebrospinal fluid (CSF)
Diabetes insipidus (DI) is a condition caused by loss of the effect of antidiuretic hormone on the collecting ducts of the kidneys, resulting in loss of free water.