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Complications of Subarachnoid Hemorrhage
The three dreaded complications of SAH include the following:
- Rebleeding
- Hydrocephalus-occurs in as many as 33-50% of patients with SAH. Intraventricular blood (in 20% of cases) acutely occludes the foramen of Monroe and Luschka and obstructs CSF outflow. This is treated by inserting a ventriculostomy catheter.
- Vasospasm-Usually develops several days after the initial SAH. May be an asymptomatic angiographic phenomenon or cause cerebral ischemia-an important cause of morbidity after SAH. Prophylactic administration of Nimodipine improved outcomes.
References
Edlow, et al. Aneurysmal subarachnoid hemorrhage: update for emergency physicians. JEM 2008