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Subarachnoid hemorrhage

Subarachnoid hemorrhage. Causes : -Trauma -Spontaneous , ruptured aneurysms ,AVM , vacuities , tumors, coagulation disorders ,cerebral artery dissection , sickle cell disease , drugs , spinal AVM. Aneurysmal SAH. ANNUAL RATE 10-30%

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Subarachnoid hemorrhage

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  1. Subarachnoid hemorrhage Causes : -Trauma -Spontaneous , ruptured aneurysms ,AVM , vacuities , tumors, coagulation disorders ,cerebral artery dissection , sickle cell disease , drugs , spinal AVM

  2. Aneurysmal SAH ANNUAL RATE 10-30% 10%DIE BEORE REACHIUNG THE HOSPITAL Peak age 55-60 years 20% can occur in age 15-45y Old age has a higher proportion with a severe neurological grade

  3. Risk factors for SAH Hypertension Oral contraceptives Substance abuse pregnancy and parturition

  4. Outcome 10% die 10%mortality within first few days 30% moderate to severe disability

  5. Clinical picture Headache Meningismus Coma Ocular haemorrhage

  6. Investigations Images LP ANGIO MR-ANGIO

  7. GRADING SAH Hunt& Hess G1 asymptomatic G2 moderate to severe headache nuchal rigidity G3 confusion G4 Stupor moderate to severe hemiparasis G5 deep coma

  8. G0: unruptured G1a

  9. Management Concerns Monitoring and tubes Admitting orders I V fluids Medication Oxygen Hyponatremia& cardiac problems

  10. Rebleeding Vasospasm( DIND)

  11. TREATMENT OF VASOSPASM PREVENTION HYPERDYNAMIC THERAPY Hypertension , hypervolemia hemodilution

  12. Cerebral aneurysm Treatment options

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