UMEM Educational Pearls

Category: Vascular

Title: Subarachnoid Hemorrhage-Complications

Keywords: subrachnoid hemorrhageRebeleeding (PubMed Search)

Posted: 8/19/2008 by Rob Rogers, MD (Updated: 12/9/2019)
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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