Symptoms Sudden onset headache (70-80%):'Worst ever' or 'thunderclap' in natureOccipital location is classicSentinel headache in 40%Nausea and vomiting (77%) Signs Fluctuating / loss of consciousness (53%)Signs of meningism (35%):Neck...
Key PrinciplesSecure the airway if obtundedInstigate neuroprotective measuresManage hypertension to prevent rebleeding whilst maintaining CPPSecure the aneurysm earlyMonitor for and manage complications Resuscitation & Supportive Care Consider need for...
Coiling Clipping Stenting Trapping Endovascular treatment which involves navigating a catheter to the aneurysm site under fluoroscopic guidanceA microcatheter is then advanced into the aneurysm sac and metal coils are depositedCoils arrest blood flow and induces...
Should be an MDT decision made by experienced surgeons and radiologists Decision based on: Characteristics of the patient: Surgical approach favoured in younger age and in presence of space occupying ICH Radiological approach favoured in older age, poor grade SAH and...
RCT: ISATMolyneux et alLancet (2002)View Paper Intervention Endovascular coiling vs. surgical clipping for acute ruptured intracranial aneurysm Population 2143 with ruptured intracranial aneurysms Conclusion Risk of death or dependence at 1 year (primary outcome) was...
