William Edward Hunt (1921 - 1999) was an American neurologist and neurosurgeon. He is eponymous with the ophthalmologic entity Tolosa-Hunt syndrome, and the Hunt-Hess classification for intracranial haemorrhages.
65 year old male who was brought to the Emergency Department following an out-of-hospital cardiac arrest. Describe and interpret this ECG. LITFL Top 100 ECG
22 year old female presents with sudden onset of severe occipital headache. Describe and interpret this ECG. LITFL Top 100 ECG
Subarachnoid Haemorrhage Patient Hot Case
Monitoring in the critically ill subarachnoid haemorrhage patient is primarily to detect 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
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
You manage a young male with a subarachnoid haemorrhage. You are called to review because the patient has started to pass green urine