Subarachnoid hemorrhage

Subarachnoid hemorrhage

    * Introduction
    * Clinical
    * Diagnostic Laboratory
    * Surgery
    * Medical Treatment
Subarachnoid hemorrhage (HSA) is a special pathology in neurological disease, especially in young she appeared in 'full health.'' It is important to note that 60% of people with HSA are women, the risk may be potentiated by oral contraceptive use. HSA is an important cerebrovascular complications of pregnancy, was reported at a rate of 1:1100 - 1:2500 for pregnant women. 
 HSA is characterized by the penetration of blood in the subarachnoid space, causing a meningeal syndrome. If blood is present in parenchyma, speaking cerebromeningee bleeding.
Blood from the subarachnoid space may come from four sources: - The vessels of the brain that normally found in this space; - A cerebral parenchymal hemorrhage, in which the blood can reach the subarachnoid space by breaking through the cortex or ventricular flooding; - Choroid plexus following the path of the ventricular system; - Following rupture of the arachnoid subdural space.
In terms of cause and manner of production, the HSA is divided into: - Primary - in which case the bleeding is the source of the subarachnoid space or spinal vessels, and bleeding occurs spontaneously; - Secondary - in which case the blood comes from the brain parenchyma.
Causes  
The most common causes of HSA are sacular intracranial aneurysm rupture and intracranial arteriovenous malformations. Other causes are the break-in subarachnoid space of intracerebral hemorrhage, bleeding within perimezencefalice tanks or systemic disease. Part of HSA have unknown etiology.
The incidence of cerebral artery aneurysms cerebral arterial aneurysms varies between 39% and 76.1%. The location of cerebral aneurysms is different. Place the choice of a complex arterial aneurysm anterior cerebral artery - anterior communicating artery (30%), followed by internal carotid artery junction - posterior communicating artery (25%) and mijIocii cerebral artery branches (13%). Aneurysms usually predominant on the right side.
Aneurysms are classified as: saculare (or damage), mycotic, traumatic, arteritic Lueta, arteriosclerotice and dissected. Aneurysm dimensions differ from the size of a pea, up to giant proportions. In an aneurysm was a clot can be organized that will cause progressive enlargement and rupturing. Evolution aneurysms is unpredictable and depends on factors difficult to identify. It appears that hypertension promotes their growth. It's known association with other malformations extracranial intracranial aneurysms as: polycystic kidneys, coarctation of aorta, fibromuscular dysplasia.
Aneurysms larger than 2.5 cm in diameter are known as giant aneurysms. They usually occur in the intracranial internal carotid artery, the bifurcation of the middle cerebral artery and distal portion of the basilar artery. Their effect is mainly manifested by cranial nerve compression.