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
Bacterial ventriculitis (BV) is inflammation of the ventricular drainage system, usually due to bacterial infection of the cerebrospinal fluid (CSF)
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
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.
A 'volume-targeted' approach to the management of TBI developed by a Swedish group (not ABBA), based on physiological volume regulation of the intracranial compartments. The Lund concept contradicts the prevailing strategem of titrating CPP to match ICP in TBI
Temperature and TBI. Induced hypothermia has been used for years to reduced cerebral metabolic rate; manipulation of temperature has been shown to effect certain types of brain injury (therapeutic hypothermia in out-of-hospital cardiac arrest).
polyuria following TBI is common; multiple causes, some of which imply a poor prognosis. Goal is to identify and treat the cause and any complications
Brain impact apneoa is an under-appreciated cause of morbidity and mortality in traumatic brain injury (TBI)
Limitations of CT head scan in Traumatic Brain Injury (TBI)
Cerebral Perfusion Pressure (CPP) in Traumatic brain injury (TBI). Cerebral Perfusion Pressure (CPP) = MAP – ICP or CVP (whichever is highest)