Complications of Subarachnoid Hemorrhage

The three dreaded complications of SAH include the following:

• Rebleeding
• Hydrocephalus-occurs in as many as 33-50% of patients with SAH. Intraventricular blood (in 20% of cases) acutely occludes the foramen of Monroe and Luschka and obstructs CSF outflow. This is treated by inserting a ventriculostomy catheter. 
• Vasospasm-Usually develops several days after the initial SAH. May be an asymptomatic angiographic phenomenon or cause cerebral ischemia-an important cause of morbidity after SAH. Prophylactic administration of Nimodipine improved outcomes. 

References

 Edlow, et al. Aneurysmal subarachnoid hemorrhage: update for emergency physicians. JEM 2008