Cerebral Aneurysms Complications

'EXPANDING' INTRACEREBRAL HAEMATOMA

Brain swelling around an intracerebral haematoma may aggravate the mass effect of the haematoma; this may cause a progressive deterioration in conscious level or progression of focal signs.

EPILEPSY

Epilepsy may occur at any stage after SAH, especially if a haematoma has caused cortical damage.

Seizures may be generalised or partial (focal). EXTRACRANIAL COMPLICATIONS

Myocardial infarction/cardiac arrhythmias: electrocardiographic and pathological changes in the myocardium are occasionally evident after SAH, and ventricular fibrillation has been recorded. These problems are likely to occur secondarily to catecholamine release following ischaemic damage to the hypothalamus.

Pulmonary oedema: this occasionally occurs after SAH, probably as a result of massive sympathetic discharge; note the 'pink, frothy' sputum and typical auscultatory and chest X-ray findings.

Gastric haemorrhage: bleeding from gastric erosions occasionally occurs after SAH but rarely threatens life.

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