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Aneurysmal Subarachnoid Haemorrhage - Part 1: Pre-operative nursing management diagnosis, complications and treatment: A composite case study
Andrew Scanlon
Department of Neurosurgery, Austin Health; La Trobe University/Austin Health Clinical School of Nursing, Heidelberg VIC
Abstract
Patients who survive an aneurysmal subarachnoid haemorrhage (ASAH) describe it as being the worst headache ever, multiplied one hundred-times over. It is a debilitating and life threatening condition, which affects approximately 6.5 people per 100,000 throughout Australia and New Zealand every year (The ACROSS Group, 2000).
When caring for a patient post ASAH, meticulous monitoring of the patient's neurological, cardiovascular, hepatic, endocrine, renal, and respiratory functions are vital. This is due to both the initial ASAH and its complications such as rebleed, cerebral vasospasm, hydrocephalus, cerebral oedema, seizures as well as adverse reactions to measures to counteract these potential problems. If left undiagnosed and untreated this can cause significant long-term morbidity as well as potential mortality.
This article presents a composite patient highlighting clinical manifestations of ASAH, its associated complications as well as various methods of detecting, preventing and treating them.
Keywords
aneurysmal subarachnoid haemorrhage, nursing management, rebleed, CT scan, Glasgow coma scale, intra-arterial digital substraction angiography, cerebral vasospasm, Nimodipine, hydrocephalus, cerebral oedema, seizures, pre-operative care
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