Neurocritical Care Review Course-Subarachnoid Hemorrhage

Video Transcription

Video Summary

In this video, Dr. Nikhil Patel discusses subarachnoid hemorrhage (SAH) and its management. SAH is the least common type of stroke, but has a high impact on death and disability. It is primarily caused by a ruptured intracranial aneurysm. The presentation of SAH includes severe headache, nausea, vomiting, and loss of consciousness. Diagnosis is typically made through head CT, but MRI and lumbar puncture can also be used. Treatment involves stabilizing the patient and addressing complications such as hemodynamic instability, respiratory complications, hydrocephalus, aneurysm re-bleeding, and seizures. The severity of SAH can be assessed using grading scales. The management of SAH also focuses on preventing and treating delayed cerebral ischemia (DCI) which is a major source of brain injury. Diagnosis of DCI is challenging, but transcranial Doppler and other imaging modalities can be used. Treatment options for DCI include induced hypertension, endovascular therapy, and prophylactic use of nimodipine. Other management considerations include fever control, hyponatremia, venous thromboembolism, hyperglycemia, and anemia.

Asset Caption

Nikhil Patel, MD

Keywords

subarachnoid hemorrhage

management

intracranial aneurysm

diagnosis

treatment

delayed cerebral ischemia

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