Subarachnoid Haemorrhage: Complications
SAH Complications including Neurological deterioration; Seizures; Hyponatremia; Cardiac complications; Re-bleeding; Vasospasm
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: Prognostication - some factors are modifiable; mortality rates currently ~35%; 15% die prior to reaching hospital; 8-20% long-term dependence
Subarachnoid Haemorrhage (SAH) potentially fatal bleeding into the subarachnoid space, usually due to a ruptured cerebral aneurysm
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)
Cerebral Salt Wasting: also now known as renal salt wasting; hyponatraemia not always required to make diagnosis, but often present; cerebral lesion + excess renal loss of Na+ and Cl-; cerebral lesions: SAH, TBI, tumour
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) versus Cerebral Salt Wasting
Basal metabolic rate
Cachexia refers to weight loss and skeletal muscle wasting due to illness where the body does not reduce catabolism (unlike the adaptive reduction in protein metabolism that occurs in starvation). Mechanisms not clearly understood