What is your strategy for treating persistent headaches in the aftermath of subarachnoid hemorrhage?
Does your strategy change depending on whether or not it is a secured or unsecured aneurysmal SAH?
Answer from: at Community Practice
In the immediate aftermath of a subarachnoid hemorrhage, regardless of whether the aneurysm has been secured or not, the following strategies can be employed to manage headaches:
Headache Cocktail: This may consist of magnesium infusions, Benadryl, and an antiemetic like Compazine. Magnesium infu...
Comments
at University of Minnesota I love the idea of magnesium infusions. Gabapentin...
at Cooper Medical School of Rowan University We are also implementing nerve blocks in the neuro...
at UPMC How effective has anyone found steroids in reducin...
at ChristianaCare In my experience, they can be very helpful, but th...
I have encountered several male patients with non-aneurysmal SAH who experienced persistent and significant headaches. These patients, aged between 35 and 45, were all smokers, and I strongly suspected that two of them had OSA. The headaches sounded migrainous and none of the patients endorsed havin...
Comments
at UPMC That was a very good and concise summary.
at Huntsville Hospital I have recently had a post-nonaneurysmal SAH patie...
In the hyper-acute phase (before securing the aneurysm), I typically administer IV Fentanyl to help patient feel at ease. However it's crucial not to overuse it, as this can lead to lethargy and potentially compromise the accuracy of the neuro-exam. Once aneurysm is secured, I initiate Gabapentin as...
I love the idea of magnesium infusions. Gabapentin...
We are also implementing nerve blocks in the neuro...
How effective has anyone found steroids in reducin...
In my experience, they can be very helpful, but th...