SUBARACHNOID HAEMORRHAGE (SAH)
It is a type of intracranial haemorrhage into the subarachnoid space usually from basal cisterns. It may be spontaneous or following trauma.there is bleeding in the space that surrounds the brain. Most often, it occurs when a weak area in a blood vessel (aneurysm) on the surface of the brain bursts and leaks. The blood then builds up around the brain and inside the skull increasing pressure on the brain.
CAUSES
- Intracranial aneurysms—commonest cause (50%)
- Hypertension
- A-V malformations
- Blood dyscrasias
- Anticoagulant drugs
- Brain tumours (malignant
CLINICAL FEATURES
- Sudden onset of severe headache with vomiting.
- Features of raised intracranial pressure.
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- Neck stiffness.
- Focal neurological deficits: hemiplegia, dysphasia.
- Eye changes: ptosis, dilated pupil, changes in the eyeball movements.
- Sudden loss of consciousness.
- Features of brain oedema and cerebral ischaemia.
- In 40% of recovered patients, rebleeding occurs in 6–8 weeks which is commonly fatal.
INVESTIGATIONS
- Lumbar puncture should be done to differentiate from meningitis.
- In subarachnoid haemorrhage, blood stained CSF is collected.
- CT scan.
- Carotid and vertebral angiogram
- MRI
HOMOEOPATHIC MANAGEMENT:
- ARNICA
- AURUM MUR
- BARYTA CARB
- BOTHROPS
- HAEMAMALLIS
- CROTOLUS HORRIDUS
- PHOSPHORUS