How to treat aneurysmal subarachnoid hemorrhage

The clinical treatment of aneurysmal subarachnoid hemorrhage must be carried out scientifically, because these diseases pose a relatively great threat to human life. Patients are advised to keep their airways open, maintain a stable respiratory circulation, and avoid excitement and exertion.

1. Clinical treatment

After SAH is confirmed, cerebral angiography or CT angiography (CTA) should be performed as soon as possible. Once it is confirmed that the intracranial aneurysm is ruptured, craniotomy, clipping or intravascular embolization should be performed as soon as possible. The main purpose of SAH treatment is to prevent and treat complications such as rebleeding, vasospasm and hydrocephalus, and to reduce mortality and disability rates.

2. General treatment and symptomatic treatment

Monitor changes in vital signs and neurological signs, keep the airway open, and maintain stable breathing and circulation. Lie quietly in bed, avoid excitement and exertion, keep bowel movements normal, and use sedatives, antitussives and anti-epileptic drugs symptomatically.

3. Reduce intracranial pressure

Appropriately limit fluid intake to prevent and treat hyponatremia. Dehydrating agents such as mannitol and furosemide are commonly used in clinical practice to reduce intracranial pressure, and albumin may also be used as appropriate. When accompanied by a large intracerebral hematoma, surgery can be performed to remove the hematoma to reduce intracranial pressure and save lives.

4. Prevent and treat rebleeding

(1) Rest quietly and stay in bed for 4-6 weeks;

(2) Control blood pressure. Severe pain may cause high blood pressure in patients, so be careful to eliminate factors such as pain.

(3) Use antifibrinolytic drugs to prevent rebleeding caused by dissolution of blood clots around the aneurysm. Commonly used drugs include aminocaproic acid and aminobenzoic acid.

(4) Surgical removal of aneurysms is the best way to prevent rebleeding of aneurysmal SAH.