Delayed ischemia due to cerebral vaso spasm post operate subarachnoid Essay

Delayed ischemia due to cerebral vaso spasm post operate subarachnoid haemorrhage clipping - Essay Example This disease mostly strike at fairly young age and proved to be fatal. Its effects are similar to the cerebral infarction or intracerebral hemorrhage. Diagnosis and acute management of the subarachnoid represents a great challenge to the neurologists, neurosurgeons, interventions radiologists and intensivists. In this case study we analyze the factors that are involved in the subarachnoid hemorrhage and their relation with the delayed ischemia that is occur because of the cerebral vasospasm. In this study we also evaluate the role of the practitioners regarding to this disease. In most of the population the incidence of subarachnoid hemorrhage is 6-7 individuals per 100, 000 persons in a year. Incidence of subarachnoid hemorrhage increases with the age. Their risk factors are smoking, constant or excessive alcohol intake and hypertension. In the patients who have positive family history for subarachnoid hemorrhage, the average age at which the disease strikes to them is younger age t han in patients with the sporadic subarachnoid hemorrhage. So, genetic factors also play significant role in this disease. Factors that are involved in the rupture of the arachnoid membrane are very complex; it happens because of the sudden increase in trans mural arterial pressure, activities such as exercise, straining and intercourse are reported as 20% necessary factor in the prevalence subarachnoid hemorrhage (Zentner, et al., 1996). The main characteristic symptom of subarachnoid hemorrhage is the head ache. This head ache is different from the normal head ache that usually occurred in individuals in their daily routine life due to extensive hard work. Head ache usually last 1- 2 weeks and sometime longer and of very high intensity. Vomiting is also the characteristic of this disease but it is not distinctive one because it also occurred in the patients of non-hemorrhagic. Focal neurological deficits occur when an aneurysm compresses a cranial nerve or bleeds into the brain pa renchyma or from focal ischemia due to acute vasoconstriction immediately after aneurysmal rupture. Sometimes, therefore, the clinical manifestations of a ruptured aneurysm are indistinguishable from a stroke syndrome from cerebral infarction. Complete or part third-nerve palsy is a well-recognized sign after rupture of aneurysms, mostly of the internal carotid artery at the origin of the posterior communicating artery (Wartenberg, et al., 2006). Systematic feature which are associated with the subarachnoid hemorrhage are sever hypertension, hypoxemia and electrocardiographic changes which can mimic the myocardial infarction and lead to erroneous examinations and treatments. The first investigation if the subarachnoid hemorrhage is suspected is CT scan. Their detection depends on the amount of blood that leaked into the subarachnoid space. The indication of surgery in patients of subarachnoid hemorrhage can be done if the overall medical condition of the patient is out of control, l ike aneurysm size and location, accessibility of the aneurysm for surgical repair, and presence or absence of thrombus, are also important (Wartenberg, et al., 2006). Cerebral vasospasm is the intensive and prolonged vasoconstriction of the large conducting arteries in the subarachnoid space that is initially surrounded by the clot. The further narrowing of the vessels develop gradually over the first few days after the aneurysmal ruptur