SAH

AHEC “Time is Brain” 2014
Kirk’s Notes

1. Increase incidence in winter and spring
2. Missed dx 12% with 4X risk of death
3. Use Hunt and Hess SAH grading to help family with prognosis
4. Treat early hydroceph. Any ventriculomegally should receive a drain.
5. Better outcomes with coiling than clipping although center dependent
6. Can decrease BP acutely to decrease initial risk of rebleeding
7. Consider amicar if transfer to Duke is in process
8. Fisher grade predicts DCI
9. If increased MAP doesn’t treat DCI, repeat angio.
10. Duke has non-refusal policy for SAH