Subarachnoid Hemorrhage – Recovery

Recovery in Infants Who Have a Subarachnoid Hemorrhage

Prognosis and recovery vary greatly in infants. Patients may suffer either short-term or long-term deficits, or a mixture of both, as a result of the bleed. Once your baby is discharged from the hospital, treatment might continue at a facility that offers personalized rehabilitation therapies for babies who have suffered serious brain trauma. A doctor who specializes in such rehabilitation will oversee the infant’s care, which may include both physical and occupational therapy, as well as cooling therapy which is usually carried out swiftly after a brain hemorrhage is discovered.

Common problems that affect people who suffer a brain injury as infants include memory and thinking difficulties and physical limitations. Some issues may disappear as the child grows up, and with the help of therapy and healing.

Importantly, as the baby grows up, he or she should take moderate exercise, develop a steady sleep pattern, and maintain a healthy diet. All of these can go a long way toward providing clear thinking, good speech, and improved concentration skills, as well as better energy levels.

Early Treatment

Initial treatment aims to prevent further bleeding on the brain and reduce the likelihood of secondary complications. The most imminent danger is rebleeding, and the first aim is, therefore, usually, to block the aneurysm.

Another complication often experienced is delayed cerebral ischemia as a result of vasospasm. However, the risk can be reduced by maintaining circulatory volume.

Supportive Management in Babies

Babies who suffer a subarachnoid hemorrhage may be referred to a specialist neurosurgical unit for investigation and definitive treatment. Ideally, the transfer should take place within 24 hours of identifying the bleeding.

Supportive care usually provided to babies includes ventilation and intubation in babies with a depressed level of consciousness.

Preventing Seizures

The use of medication to prevent seizures is somewhat controversial and has been associated with worst-case outcomes. Typically, babies undergo cooling therapy as soon as possible to help restrict the flow of blood and to prevent secondary consequences like seizures.

Preventing Rebleeding

Re-bleeding is a common occurrence and can be difficult to predict. After the first 24 hours of bleeding on the brain has passed, the re-bleeding risk remains at about 40 percent over the following four weeks. Interventions aim to reduce the risk as early on as possible. The decision as to how to prevent re-bleeding in infants will be taken by the operating team and will depend on the size of the hemorrhage and the baby’s overall condition.

Ventricular Drainage

Relief of hydrocephalus, a condition where there is an accumulation of cerebrospinal fluid in the brain that can increase pressure in the baby’s skull and lead to seizures and sleep deprivation, can complicate issues both in the short-term and in the long-term. Relief of the condition can cause massive improvement in the baby’s clinical status. Surgical intervention can be contraindicated in those patients who do not respond to medically stabilizing measures, those with other medical problems, or where the hemorrhage is complicated. Babies will be closely monitored for the development of any treatable complications, particularly hydrocephalus, electrolyte imbalances, cerebral ischemia, and hypotension.

Recovery from a Subarachnoid Hemorrhage

How well a baby recovers will depend on how premature he or she is and the grade of the hemorrhage. Less than half of infants with lower-grade bleeding will develop long term problems. But, severe bleeding can lead to problems with controlling movement as well as developmental delays. Sadly, up to a third of infants with severe bleeding on the brain die. Pregnant women who are at a high risk of delivering early are usually given medications known as corticosteroids which can help reduce the baby’s risk of brain bleeding. Those women who are on medicines that may affect bleeding risks should take vitamin K prior to delivery.