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Subarachnoid Hemorrhage - Life Care and Treatment Planning

Subarachnoid hemorrhage (SAH) is becoming easier to diagnose even in babies who don’t exhibit symptoms. A clinical study including 397 full-term babies suggests that of 40 babies with a brain bleeding problem, 24 had SAH. This experiment sees the condition as one of the most common causes of brain injury in babies.

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SAH can often cause an increase in intracranial pressure, which can lead to permanent brain damage. This is why a proper diagnostic process is needed in babies considered at risk. Very often, SAH will be characterized by seizures that will typically be observed between the second and seventh day of the baby’s life. Other neurological symptoms are also possible. It’s highly likely for SAH to produce long-lasting neurological problems in the child. This is the main reason why a proper life care plan will have to be determined early on.

Depending on the severity of the hemorrhage, it may eventually necessitate the use of medications, physiotherapy and specialized equipment to guarantee a high quality of life and at least some degree of independence.

SAH Treatment and Management

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The first stage of treatment has to occur as soon as the hemorrhage is diagnosed. In this instance, the aim of the therapy would be to protect the brain from damage.

One very important fact to understand is that the therapeutic approaches applied to adults who suffer from brain hemorrhages aren’t always recommended in babies and children. The use of thrombolytic drugs (also known as clot-busting medications) isn’t recommended for children.

On occasions, anticoagulants and antiplatelet therapy will be utilized to deal with aneurysms. Whenever the SAH causes a massive increase in intracranial pressure, measures will have to be undertaken to drain some of the fluid and the blood. In some of the most serious cases, hemicraniectomy (a removal of a small portion of the skull) will be required, and such a procedure may potentially be life-saving.

While medications and other procedures are administered, a child should undergo diagnostic scanning every several days. It’s possible for the hemorrhage to re-occur or for the medications to fail to deliver the desired results. Thus, medics will need to figure out how SAH is progressing and whether an adjustment in the therapeutic approach will be required.

Long-Term Life Care and Neurological Symptom Management

It’s possible for the emergency care that newborns and babies receive at the hospital to still fail. SAH can potentially result in permanent brain damage. In such instances, long-term life care and therapeutic strategies will be required to ensure optimal conditions for the patient.

Medications may be prescribed to treat the most common ">SAH complications. A few of those include seizures, vasospasms, cardiac issues, pulmonary complications, hyponatremia and hydrocephalus.

The most important thing to understand is that SAH in itself is not a long-term problem. The permanent brain damage it may contribute to, however, will necessitate a life care plan because of the various neurological problems such children may experience.

A few of the most common types of permanent damage that a subarachnoid hemorrhage may contribute to include the following:

  • Chemical meningitis
  • Cerebral palsy
  • Eventual rebleeding in the future
  • Vasospasms
  • Vision disturbances or vision loss
  • Epilepsy (it occurs in about 1 out of 20 people suffering from a subarachnoid hemorrhage)
  • Cognitive impairments
  • Motor function impairments
  • Emotional problems like clinical depression, post-traumatic disorder, and social anxiety

The management of these complications is as important as the initial intervention. Depending on the severity of the symptoms and the issues that the patient is going through, medications, physiotherapy, and psychotherapy may be required.

Blood pressure control will also be required because this complication happens to be quite common among SAH sufferers. In addition, irregularities in blood pressure could potentially contribute to the reoccurrence of a subarachnoid hemorrhage. The perceived risk of vasospasm will also have to be assessed for the selection of the right therapy.

Another complication that needs to be considered for the long-term management of subarachnoid hemorrhages is the increased risk of anemia. Anemia is a rather common occurrence after SAH. To overcome the issue, red blood cell transfusions are recommended.

As already mentioned, children that suffer from SAH are also at a higher risk of experiencing cardiovascular issues later on in life. The treatment for such is a bit tricky. Nitrates are typically prescribed to strengthen circulation. At the same time, such medications are linked to an increase in intracranial pressure. An experienced physician will have to be consulted for the identification of the best therapy that will enhance cardiovascular health without increasing the risk of further brain damage.

SAH is a serious issue that calls for adequate management. The morbidity and mortality rates of SAH are high. The same applies to permanent neurological damage stemming from the condition. One of the biggest goals in long-term management is preventing the occurrence of a re-bleeding. Good life care should also focus on diminishing the neurological symptoms, regular screening and the selection of the right pharmacological products that will control both the risk factors and the common complications stemming from such a brain hemorrhage.