Mednet Logo
CommunityNeurology

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?
4 Answers
Mednet Member
Mednet Member
Neurology · ChristianaCare
Answered on

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 infusi...

Join for free or sign in to see the full answer

Mednet Member
Mednet Member
Neurology · Charleston Area Medical Center/CAMC Institute for Academic Medicine
Answered on

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...

Join for free or sign in to see the full answer

Mednet Member
Mednet Member
Neurology · University of Minnesota
Answered on

Check for vasospasm and hydrocephalus in either case.

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Neurology · HCA Houston Healthcare
Answered on · Updated on

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...

Join for free or sign in to see the full answer