Neurological Critical Care Flashcards

A patient with an aneurysmal subarachnoid hemorrhage is at highest risk for cerebral vasospasm during which time frame?

Answer: Days 4 to 14 after the bleed

Vasospasm peaks between days 4 and 14 following aneurysmal subarachnoid hemorrhage.

Which medication is given to reduce the risk of poor outcomes from cerebral vasospasm after subarachnoid hemorrhage?

Answer: Nimodipine

Nimodipine, a calcium channel blocker, improves neurologic outcomes after SAH-related vasospasm.

The Hunt and Hess scale is used to grade the severity of which condition?

Answer: Subarachnoid hemorrhage

The Hunt and Hess scale grades the clinical severity of subarachnoid hemorrhage.

A patient with SAH develops hyponatremia, hypovolemia, and high urine sodium with signs of dehydration. Which diagnosis is most consistent?

Answer: Cerebral salt wasting

Cerebral salt wasting causes hyponatremia with volume depletion and renal sodium loss.

Which intervention is contraindicated for a patient with a sudden severe headache described as 'the worst headache of my life' before the aneurysm is secured?

Answer: Activities that increase intrathoracic pressure such as straining

Straining raises intracranial and arterial pressure, risking aneurysm rebleeding before it is secured.

Triple-H therapy historically used for cerebral vasospasm includes hypertension, hemodilution, and which third component?

Answer: Hypervolemia

Triple-H therapy combines hypertension, hemodilution, and hypervolemia to improve cerebral perfusion.

What is the gold standard diagnostic test to identify the source of an aneurysmal subarachnoid hemorrhage?

Answer: Cerebral angiography

Cerebral angiography is the gold standard for locating the aneurysm responsible for SAH.