Complications of subarachnoid haemorrhage
Death
Persistent neurological deficit
Re-bleeding
Larger aneurysms, HTN, age, smoking and multiple aneurysms all predict this.
Vasospasm
Leading to delayed cerebral ischaemia (hence nimodipine)
Most common at three days, can happen up to two weeks
Ealry clipping or coiling does NOT get rid of this
Epilepsy (in 5%)
Give antiepileptics if seizures, tapering down over 6 months if seizure-free
Raised intracranial pressure
Treat with mannitol
Hyponatraemia
Can be SIADH (treatment being fluid restriction) or cerebral salt-wasting (treatment being isotonic saline). May be difficult to distinguish