Subarachnoid Haemorrhage: Initial Management
SAH initial management includes: resuscitation; specific treatment; supportive care and monitoring; disposition
Category Medical Specialty
Subarachnoid Haemorrhage: Prognostication
Subarachnoid Haemorrhage: Prognostication - some factors are modifiable; mortality rates currently ~35%; 15% die prior to reaching hospital; 8-20% long-term dependence
Subarachnoid Haemorrhage (SAH)
Subarachnoid Haemorrhage (SAH) potentially fatal bleeding into the subarachnoid space, usually due to a ruptured cerebral aneurysm
Vasospasm in Subarachnoid Haemorrhage
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
Ventriculitis
Bacterial ventriculitis (BV) is inflammation of the ventricular drainage system, usually due to bacterial infection of the cerebrospinal fluid (CSF)
Scleroderma
Scleroderma = autoimmune mediated widespread collagenous deposition. Limited form: Calcinosis, Raynauds, Esophageal dysfunction, Sclerodacytaly and Telangiectasia (CREST syndrome)
Systemic Lupus Erythematosus
Systemic Lupus Erythematosus (SLE) = chronic, multi-system disease commonest in young females; wide spread antibodies -> produce tissue damage
Polyangiitis – MPA, GPA, EGPA
Polyangiitis - MPA, GPA, EGPA: similar but different diseases; positive Antineutrophil cytopasmic antibiodies (ANCA); renal histology (focal necrotizing, pauci-immune glomerulonephritis)
John Birkett
John Birkett (1815-1904) was an English general surgeon.
Bispectral Index (BIS) Monitoring
Bispectral Index (BIS) Monitoring: BIS monitor was developed by Aspect Medical Systems; BIS = bispectral index; other 'depth of anaesthesia' monitors exist (e.g. Entropy)
Isoniazid toxicity
Isoniazid toxicity, like other hydrazines, primarily cause life-threatening seizures and lactic acidosis through depletion of vitamin B6. The antidote is pyridoxine
Acute Fatty Liver of Pregnancy
Acute Fatty Liver of Pregnancy: hepatic dysfunction + microvesicular infiltration of hepatocytes; thought to be a variant of PET; fetal and maternal mortality = 20%