J Clin Outcomes Manage
Aneurysmal subarachnoid hemorrhage
Brown RJ, Dhar R
ABSTRACT: Objective: To provide an overview of the diagnosis, complications, and treatment of aneurysmal subarachnoid hemorrhage (SAH). Methods: Review of the literature in the context of a clinical case. Results: SAH is a neurologic emergency most commonly presenting as sudden severe (“thunderclap”) headache. All patients with unusual, new, or “worst headache of their life” require thorough evaluation. The diagnosis of SAH is made by head CT or lumbar puncture; a cerebral angiogram is required to evaluate for source of bleeding, most commonly an intracranial aneurysm. Early management centers on the prevention of aneurysmal rebleeding, including surgical or endovascular intervention to “secure” the aneurysm. Physicians should be knowledgeable with regard to the myriad complications that may occur after SAH, ranging from hydrocephalus and vasospasm to hyponatremia and cardiopulmonary dysfunction. Conclusion: Despite serious neurologic and systemic complications, outcomes for patients with aneurysmal SAH can be significantly improved with an aggressive and informed multidisciplinary approach
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