Cerebral Aneurysms Management Following

Headache requires analgesia — codeine or dihydrocodeine. Stronger analgesics may depress conscious level and mask neurological deterioration. Management is otherwise aimed at preventing complications -

PREVENTION OF REBLEEDING

Bed rest: Usually enforced after SAH, although there is no evidence that this reduces the rebleed risk. Allowing the patient to use the toilet may induce less 'stress' than using a bedpan.

Antifibrinolytic agents: tranexamic acid, cpsilon aminocaproic acid.

These agents have been used for many years with the aim of preventing rebleeding by delaying clot dissolution around the aneurysm fundus. Antifibrinolytics do reduce rebleeding (by more than 50%) but at the expense of increasing the incidence of cerebral ischaemia. The overall results showed no improvement in mortality or morbidity.

Activators in endothelium and tissues

Fibrinolytic mechanism

Plasminogen

Activators in endothelium and tissues

Fibrinolytic mechanism

Plasminogen

Inhibitors epsilon amino caproic acid and tranexamic acid

Inhibitors epsilon amino caproic acid and tranexamic acid

Operation: Clipping of the aneurysm neck is the only certain way of preventing rebleeding, but this technique is not always possible and other methods are sometimes employed. The timing of operation is a controversial topic.

Was this article helpful?

0 0
Stop Headache Drug Free

Stop Headache Drug Free

If you are suffering from headaches, you can make the pain stop just by following some basic but little known principles. Take 15 minutes browsing through this guide and you'll find dozens of tips to gain control in the battle against headache pain.

Get My Free Audio Book


Post a comment