Subarachnoid Hemorrhage Treatment
Treatment for a subarachnoid hemorrhage depends on the extent of the bleed and the neurological status of the patient. Treatment may include intravenous fluids, oxygen therapy, medications, and surgery to repair the bleeding vessel.
Specific treatment for subarachnoid hemorrhage may include:
- Medications to keep the patient calm:
- Elevate the head of the bed at 30 degrees
- Oxygen therapy
- Close monitoring of mental status:
- Any decline in mental status warrants a CT scan of the brain to check ventricle size (enlarged ventricles mean hydrocephalus)
- Intravenous fluids
- Medications that reduce brain swelling:
- Placement of a ventriculostomy in the event that hydrocephalus cannot be controlled with medications or mental status declines.
- Stool softeners
- Medications to control high blood pressure in subarachnoid hemorrhage:
- Keep systolic pressure no greater than 130 to 140 mm Hg
- Labetalol (Trandate, Normodyne)
- Nitroprusside (Nitropress)
- Medication that helps to reduce spasm of the bleeding blood vessel:
- Medication to reduce the risk for seizures:
- Surgery for subarachnoid hemorrhage due to cerebral aneurysm:
- The skull is opened and the opening in the vessel is closed using a clip.
- A catheter is used to introduce a coil on the inside of the blood vessel. The coil causes a blood clot to form over the bleeding segment of the vessel wall.
Subarachnoid Hemorrhage Drugs
Medications used to treat subarachnoid hemorrhage include:
- Calcium channel blocker medications for subarachnoid hemorrhage:
- Prevent spasms of the blood vessels
- Anticonvulsant medications for subarachnoid hemorrhage:
- Prevent seizures
- Antihypertensive medications for subarachnoid hemorrhage:
- Control high blood pressure
- Diuretic medications for subarachnoid hemorrhage:
- Reduce swelling around the brain
Calcium channel blocker medication:
- Simvastatin is currently being studied to see if it has benefit.
Subarachnoid Hemorrhage Specialist
Physicians from the following specialties evaluate and treat a subarachnoid hemorrhage:
Subarachnoid Hemorrhage Surgery
Surgery may be required if the subarachnoid hemorrhage is due to a ruptured aneurysm that can be repaired. An aneurysm is a bulge in the wall of an artery, caused by weakness in the wall. Surgery is used to stop bleeding from a cerebral aneurysm.
Two types of surgery are performed to treat aneurysms:
- An incision is made in the scalp and the skull is opened.
- A tiny clip is placed at the base of the aneurysm.
- Blood continues to flow through the artery, but is unable to flow through the leak in the weakened wall.
- Clipping can prevent rebleeding of an aneurysm.
- A catheter is introduced into the artery.
- A tiny coil is introduced into the artery, through the catheter
- The coil fills the aneurysm.
- The coil causes a clot to form in the aneurysm, sealing the leak.
Continue to Subarachnoid Hemorrhage Warning Signs
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