subarachnoid haemorrhage i.aneurysm and avm ii.trauma iii.infections iv.neoplasia v.toxic...

SUBARACHNOID HAEMORRHAGE

I. ANEURYSM AND AVMII. TRAUMAIII. INFECTIONSIV. NEOPLASIAV. TOXIC VI. INFLAMMATORYVII. DEGENERATIVE

CAUSES

CLINICAL FEATURES

WARNING SYMPTOMS---HEADACHE,DIZZINESS,ORBITAL PAIN,DIPLOPIA,LOSS OF VISION,MOTOR AND SENSORYDEFICIT,FITS,CRANIAL NERVE PALSY(3 NERVE),DYSPHASIASYMPTOMS OF SAH--- MENINGISM,NAUSEA,VOMOTING,OCCIPITAL HEADACHE,LATERAL HEADACHE,DYSPHASIACONFUSION,INTRA-OCULAR PAIN,ANISOCORIA,PAPILLEDEMAHOMONYMUS HEMIANOPSIA,3 NERVE PALSY,THROMBOEMBOLIC PHENOMENONGIANT ANEURYSMS AS SOLMULTIPLE CRANIAL NERVE PALSIESH

CEREBRAL VASOSPASM1) BLOOB CLOT AND DEGRADATION PRODUCT2) OXY HAEMOGLOBIN ,METHEMGLOBIN3) SEROTONIN,FDP,IRON,THROMBOXONA2,CATECH

OLAMINE,PROSTAGLANDIN,ANGIOTENSIN,VASOPRESSIN,POTASSIUM,FALL IN NITRIC OXIDE,RISE IN ENDOTHELIN

TREATED BY•3H Hypertension,Hypervolemia,Haemodilution•Calcium Channel blocker nimodipine nicardipine etc•Clot removal•Baloon angioplasty

TREATMENT OPTIONS

Microsurgical clippingGDCOILEmbolization and excision of avmGamma KnifeTreatment of other conditions according to their pathologiesICU