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Slide 3 – What is a SAH?
Aneurysm- small berry like projections that occur at bifurcations in the circle of Willis for unknown reasons
AVM- composed of abnormal appearing, dilated blood vessels tangled tightly that directly shunt arterial blood into the venous system without using the appropriate connecting capillary network-cause SAH by increasing intravascular pressure and rupturing
Trauma- self explanatory
Bacterial-cause SAH usually by septic emboli breaking off and invading and destroying the vessel wall, causing weakness then rupture


Slide 8 A&P
Acom-most common type of aneurysm 30%, and more common in men
Pcom-25 %

Slide 9 A&P
MCA- 20%
Basilar-10%
5% in vertebral artery

Slide 10 Signs & Symptoms
Headaches, vomiting, photophobia, blurred vision-due to meningal irritation
Cranial nerve deficits- loss of light reflex (dilated pupils) most common in Pcom

Slide 11 Signs & Symptoms
Hemi paresis- Weakness on one side of the body
Aphasia-a defect or loss of the power of expression by speech, writing, or signs, or a defect or loss of the power of comprehension of spoken or written language
Hemiplegia-Paralysis of one side of the body



Slide 14 Treatment
Analgesia- basic e.g. paracetamol, NSAID’s
Opiod e.g. morphine or codeine, oramorph
Nimodipine- calcium channel blocker which has shown to enhance collateral blood flow and improve long term outcome
Laxatives- prevent constipation which can lead to increased ICP
Anticonvulsants – given as prophylaxis
Triple H Therapy- used to increase cerebral perfusion pressure and cerebral blood flow and prevent vasospasm. CVP 8-10, MAP 80 -100 SBP 120-150

Slide 17 Complications
Re bleeding- occurrence as high as 30%, same signs as first bleed can happen up to ten...