Critical Care Scenarios Episode 22: Aneurysmal subarachnoid hemorrhage with Thomas Lawson
Dec 27, 2020
The discussion starts with protocols for managing subarachnoid hemorrhage, emphasizing symptoms and risk factors. A detailed case study highlights the importance of blood pressure management in severe headaches and shock. Listeners learn about the urgency of CT angiograms to locate bleeding sources. The analysis of CT images offers visual indicators for diagnosis. The chat also dives into grading systems like Hunt and Hess for better patient outcomes. Lastly, managing complications like cerebral vasospasm is crucial for preventing neurological damage.
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Neurogenic Shock and Takotsubo Cardiomyopathy
- Subarachnoid hemorrhage patients can develop neurogenic shock and Takotsubo cardiomyopathy.
- This sympathetic storm can lead to cardiogenic shock.
Aneurysmal vs. Traumatic SAH
- Aneurysmal and traumatic subarachnoid hemorrhages are distinct conditions with different complications.
- Aneurysmal SAH requires securing the aneurysm to prevent re-bleeding, a major cause of death.
CT Scan Interpretation
- When reviewing a CT scan for subarachnoid hemorrhage, look for the "hanging chicken sign".
- Also, check for intraventricular/intraparenchymal hemorrhage and hydrocephalus.