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At one time, re-hemorrhage was considered a major cause of morbidity and mortality in patients who had survived the initial hemorrhage; however, a shift to early surgical management has minimized the importance of this complication. If unprotected, 15-20% of patients will re-bleed in the first 2 weeks [21], carrying with it significant mortality and mor bidity. In most studies, there is an initial peak of re-hemorrhage in the first 48 hours of approximately 4%, which rapidly plateaus to 1-2% per day until 40 days post-hemorrhage [21]. After 6 months, there is a long-term risk of further hemorrhage of 3% per year. Approximately half to three-quarters of individuals suffering a re-bleed will die as a direct result and, in the Cooperative Study, re-bleeding was responsible for 25% of all deaths [9,14]. The risk of re-bleed is increased with poor clinical grade, posterior circulation lesions, hypertension, elderly patients and abnormal hemostatic parameters.

Control of blood pressure in order to minimize the risk of re-hemorrhage is a controversial topic. No controlled trial has ever shown that lowering of blood pressure reduces the risk of re-bleeding, although the Cooperative Study revealed that re-bleeds occurred in 16% of patients who had a systolic blood pressure of 170-240 mmHg but only 9% of those with a systolic of 94-169 mmHg. Most clinicians would suggest that extremes of blood pressure should be avoided, high blood pressure being more likely to cause a re-bleed and low blood pressure exacerbating hypoxic or ischemic cerebral damage from vasospasm.

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Reducing Blood Pressure Naturally

Reducing Blood Pressure Naturally

Do You Suffer From High Blood Pressure? Do You Feel Like This Silent Killer Might Be Stalking You? Have you been diagnosed or pre-hypertension and hypertension? Then JOIN THE CROWD Nearly 1 in 3 adults in the United States suffer from High Blood Pressure and only 1 in 3 adults are actually aware that they have it.

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