SciELO - Scientific Electronic Library Online

vol.32 número7Diferencias en el mecanismo y patrón lesional, gravedad y evolución de los pacientes politraumatizados en función del géneroPDMS o UDMS: Dos perspectivas de gestión clínica en Medicina Intensiva índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados




Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google


Medicina Intensiva

versão impressa ISSN 0210-5691


GUERRERO LOPEZ, F.; LINDE VALVERDE, C.M. de la  e  PINO SANCHEZ, F.I.. General management in intensive care of patient with spontaneous subarachnoid hemorrhage. Med. Intensiva [online]. 2008, vol.32, n.7, pp.342-353. ISSN 0210-5691.

Aneurysmal subarachnoid hemorrhage (SAH) is a neurologic emergency and often a neurologic catastrophe. Nontraumatic subarachnoid hemorrhage is characterized by the extravasation of blood into the spaces covering the central nervous system. The leading cause of SAH is rupture of an intracranial aneurysm, which accounts for about 80-85% of cases. Mortality and morbidity can be reduced if SAH is treated urgently. Sudden, explosive headache is a cardinal but nonspecific feature in the diagnosis of SAH; computered tomography (CT) scanning is mandatory in all the patients with symp toms that are suggestive of SAH. Catheter angiography for detecting aneurysms is gradually being replaced by CT angiography. Diagnosing SAH can be challenging and treatment is complex, sophisticated and multidisciplinary. Reble eding is the most imminent danger, which must be prevented by endovascular occlusion with detachable coils (coiling) or by surgical clipping of the aneurysm; the risk of delayed cerebral ischemia is reduced with nimodipine and avoiding hypovolemia; hydrocephalus can be treated by ventricular drainage. Intensive care plays a more important role in the management of SAH than in any other neurological disorder. Excel lence in neurologic diagnosis, in operative neurosurgery or neuroradiologic procedures must be accompanied by excellence in Intensive Care. This review emphasizes treatment in the Intensive Care Unit, surgical and endovascular therapeutic options and the current state of treatment of major complications such as rebleeding, cerebral vasospasm and acute hydrocephalus.

Palavras-chave : subarachnoid hemorrhage; intracranial aneurysm; vasospasm intracranial; hydrocephalus; nimodipine; embolization therapeutic; ultrasonography doppler transcranial.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )


Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons