Document Detail


Management of subarachnoid haemorrhage in a non-neurosurgical centre.
MedLine Citation:
PMID:  15819768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Subarachnoid haemorrhage is a common neurological emergency, which carries a high morbidity and mortality. It is usually caused by rupture of an intracerebral aneurysm or, less commonly, an arteriovenous malformation. Although most patients present to a non-neurosurgical hospital, they often require urgent neurosurgical or neuroradiological intervention. Whilst awaiting transfer to a neurological centre, active management of the patient must be instituted. This should include confirmation of the diagnosis with CT imaging, lumbar puncture or both, and recognition of the complications of subarachnoid haemorrhage, which include hydrocephalus, further haemorrhage and cerebral vasospasm. Medical management is directed towards maintaining adequate cerebral perfusion pressure whilst avoiding large increases in arterial blood pressure. Nimodipine therapy must be started early in an attempt to prevent cerebral vasospasm. The treatment options available at the neurological centre include surgical treatment or endovascular obliteration of the aneurysm or arteriovenous malformation.
Authors:
S R Wilson; N P Hirsch; I Appleby
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Anaesthesia     Volume:  60     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-11     Completed Date:  2005-05-19     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  470-85     Citation Subset:  AIM; IM    
Affiliation:
The National Hospital for Neurology and Neurosurgery, London, UK. sally.wilson@uclh.org <E-mail:sally.wilson@uclh.org>
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MeSH Terms
Descriptor/Qualifier:
Emergency Service, Hospital
Female
Humans
Intracranial Aneurysm / therapy
Intracranial Arteriovenous Malformations / therapy
Male
Neurosurgical Procedures / methods
Patient Transfer
Pregnancy
Pregnancy Complications, Cardiovascular / therapy
Subarachnoid Hemorrhage / complications,  diagnosis,  therapy*
Tomography, X-Ray Computed
Vasospasm, Intracranial / etiology,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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