Aneurysmal Subarachnoid Hemorrhage: A Potentially Lethal Neurological Disease

Abstract

A subarachnoid hemorrhage (SAH) is characterized by bleeding that occurs between the arachnoid and pia mater meningeal layers of the brain. This type of hemorrhage accounts for about 5% of all strokes, and the majority occur as the result of a ruptured aneurysm. The incidence of the disease varies across gender, race, and geographical locations in the world, and it carries significant morbidity and mortality. A patient with an aneurysmal SAH can present to the emergency department with an array of neurological symptoms, and thus it is imperative for ED nurses to be able to quickly recognize the signs and symptoms and initiate stabilization and treatment. This article will review the epidemiology and risk factors of aneurysmal SAH, followed by an overview of pertinent neurological anatomy and the pathophysiology of this disease. A discussion of the interventions an ED nurse may expect to initiate prior to fixation of the aneurysm will be addressed as well. Jason W. Grimm is Trauma Nurse Instructor, CSTARS Saint Louis, Saint Louis University Hospital, Saint Louis, MO.