Subarachnoid hemorrhage surgery

Subarachnoid hemorrhage Surgery, BP control, nimodipine, volume expansion, sedation, seizure prophylaxis, stool softeners, ventricular drainage Neuro status, BP, hydration status, EKG, ICP... 

History of intracranial hemorrhage or symptoms suspicious for subarachnoid hemorrhage Major surgery within past 14 days ... 

In subarachnoid hemorrhage due to a ruptured intracranial aneurysm or arteriovenous malformation, surgical intervention to clip or ablate the vascular abnormality substantially reduces mortality from rebleeding. The benefits of surgery are less well documented in cases of primary intracerebral hemorrhage. In patients with intracerebral hematomas, insertion of an intraventricular drain with monitoring of intracranial pressure is... 

Niemann DB, Wills AD, Maartens NF et al. (2003). Treatment of intracerebral hematomas caused by aneurysm rupture coil placement followed by clot evacuation. Journal of Neurosurgery 99 843-847 Olafsson E, Gudmundsson G, Hauser WA (2000). Risk of epilepsy in long-term survivors of surgery for aneurysmal subarachnoid hemorrhage a population-based study in Iceland. Epilepsia 41 1201-1205... 

A generalized tonic-clonic seizure has been attributed to propofol in a patient with tonic-clonic seizures after surgery for subarachnoid hemorrhage (46). 

No. Bleeding (and increased intracranial pressure) could be exacerbated with cranial trauma, recent cranial surgery (within 6 months), or subarachnoid hemorrhage. 

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