Eyrún Arna Kristinsdóttir¹

Sigrún Ásgeirsdóttir¹

Halldór Skúlason²

Aron Björnsson²

Vilhjálmur Vilmarsson³

Kristinn Sigvaldason¹

 

 

¹Department of Anaesthesia, ²Department of Brain Surgery, ³Department of Radiology, Landspitali University Hospital.

Correspondence: Kristinn Sigvaldason, krisig@landspitali.is

Key words: Subarachnoid hemorrhage, vasospas, poyuria,
hyponatremia, critical care treatment, rebleeding.

 

Spontaneous subarachnoid haemorrhage is characterized by extravasation of blood into the subarachnoid space without a preceding trauma. The leading cause is a ruptured intracranial aneurysm. Serious neurologic complications can occur, such as rebleeding, cerebral vasospasm and delayed cerebral ischemia. Subarachnoid haemorrhage is a serious condition with a high mortality rate and those who survive often suffer long-term consequences. Prevention of rebleeding by aneurysm repair is essential and guidelines recommend this procedure should be done as soon as possible or within 72 hours. Management requires intensive care with emphasis on accurate blood pressure control, maintaining normal fluid and electrolyte balance and monitoring the level of consciousness. All patients should be treated with the calcium channel blocker nimodipine to reduce the risk of vasospasm and delayed cerebral ischemia which are among the most serious complications of subarachnoid haemorrhage.