Management of subarachnoid haemorrhage in a non-neurosurgical centre. | |
MedLine Citation:
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PMID: 15819768 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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:
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S R Wilson; N P Hirsch; I Appleby |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Anaesthesia Volume: 60 ISSN: 0003-2409 ISO Abbreviation: Anaesthesia Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-04-11 Completed Date: 2005-05-19 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 0370524 Medline TA: Anaesthesia Country: England |
Other Details:
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Languages: eng Pagination: 470-85 Citation Subset: AIM; IM |
Affiliation:
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The National Hospital for Neurology and Neurosurgery, London, UK. sally.wilson@uclh.org <E-mail:sally.wilson@uclh.org> |
Export Citation:
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MeSH Terms | |
Descriptor/Qualifier:
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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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