Jun 21st, 2015
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Alhambra Medical University
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Subarachnoid hemorrhage is also known as or subsumesMeningeal hemorrhage. Drs. Hornik and Brorson of the University of Chicago review the epidemiology, pathophysiology, diagnostic evaluation, and treatment of spontaneous subarachnoid hemorrhage and its secondary complications, including aneurysm rebleed, hydrocephalus, hyponatremia, seizures, delayed cerebral ischemia, and cardiopulmonary problems. Newer hypotheses on the mechanism of delayed cerebral ischemia following subarachnoid hemorrhage are explained. Updated recommendations from the 2011 Neurocritical Care Society Guidelines and the 2012 American Heart Association/American Stroke Association guidelines for the management of aneurysmal subarachnoid hemorrhage are included.Key pointsSubarachnoid hemorrhage constitutes a life-threatening neurologic emergency and typically presents with a sudden severe headache, most often occurring from ruptured intracranial aneurysm.The most common diagnostic error accounting for missed diagnosis of subarachnoid hemorrhage is failure to obtain a noncontrast head CT.The most important predictive factors for acute prognosis after subarachnoid hemorrhage include level of consciousness, neurologic grade on admission, patient age, and amount of blood on initial scan.Delayed cerebral ischemia following subarachnoid hemorrhage has been considered to be a direct consequence of vasospasm; however, an emerging body of literature suggests a multifactorial etiology beyond pure cerebral a

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