Lecture On Subarachnoid Hemorrhage (SAH) Explained: Symptoms, Causes, Diagnosis & Treatment | MBBS

Описание: Welcome to this in-depth medical lecture from Santiniketan Medical College, where we delve into the critical topic of Subarachnoid Hemorrhage (SAH). This session is designed for MBBS students and healthcare professionals seeking a comprehensive understanding of this serious neurological condition.

In this lecture, you will gain a thorough understanding of:

Introduction to SAH [00:00]: Learn about the normal constituents of the subarachnoid space (vessels, CSF, cranial nerves) and how bleeding into this space defines SAH.

Clinical Presentation & Symptoms [00:49]:

Sudden, Severe Headache: Often described as a "thunderclap headache" or the "worst headache of my life."

Decreased Level of Consciousness: Understanding why SAH leads to altered mental status.

Neurological Deficits: Including weakness (hemiparesis, monoparesis), cranial nerve symptoms, and aphasia.

Neck Pain & Rigidity: Key signs that can help in early detection.

Seizures/Convulsions [04:21]: An overview of seizure manifestations in SAH.

Grading Systems for SAH [04:34]:

Hunt-Hess Scale [04:42]: Learn the different grades (Grade 1 to Grade 5) based on symptoms and neurological status.

WFNS (World Federation of Neurosurgical Societies) Scale [05:09]: Understand how this grading system utilizes GCS (Glasgow Coma Scale) and motor deficits for assessment.

Etiopathogenesis & Causes of SAH [12:50]:

Most Common Cause: Trauma.

Second Most Common Cause (Non-traumatic): Rupture of an aneurysm [14:36].

Understanding Aneurysms [14:47]: What is an aneurysm, the role of micro-inflammation, macrophages, and MMP enzymes in vessel wall weakening.

Types of Aneurysms [18:56]: Explore saccular, fusiform, dissecting, and mycotic aneurysms, with a focus on the most common types.

Other Causes: Arteriovenous Malformation (AVM), Dural Arteriovenous Fistula (DAVF), and coagulopathies [23:47].

Risk Factors for Aneurysm Rupture [24:25]: Hypertension, smoking, alcohol, cocaine use, and estrogen deficiency.

Pathophysiology & Complications [26:22]:

Increased Intracranial Pressure (ICP) [26:40]: The impact of rising ICP.

Vasospasm [27:34]: How blood products, particularly oxyhemoglobin, cause cerebral vasospasm leading to delayed cerebral ischemia and neurological deficits. Learn about the use of Nimodipine to prevent this.

Hydrocephalus [38:28]: Understanding its development and management, including osmotic diuretics like Mannitol and ventriculoperitoneal (VP) shunt placement.

Hypovolemia & Hyponatremia [35:16]: Explaining the role of BNP in fluid and electrolyte imbalances.

Xanthochromia [34:09]: The characteristic yellowish discoloration of CSF due to bilirubin breakdown.

Diagnosis & Management [41:14]:

Confirmatory Diagnosis: Plain CT scan of the brain, identifying hyperdense areas in the subarachnoid space.

Localizing the Aneurysm: Cerebral angiography for precise identification.

Emergency Management: ICU admission, ABC (Airway, Breathing, Circulation) management, and symptomatic therapies (headache, anti-seizure medication).

Definitive Treatment: Endovascular therapy (coiling, embolization) and surgical clipping for aneurysm repair to prevent re-rupture [44:13].

Surgical Procedures: Discussion of hemicraniectomy for managing severe ICP.

This lecture provides a thorough overview of SAH, making it an essential resource for medical students and anyone interested in neurology.


SANTINIKETAN MEDICAL COLLEGE & HOSPITAL
Real Classroom Demonstration/Lecture
On: MEDICINE Dr. Sk. Sarafat Hossain
(MBBS Batch: 2022-23)
Conducted on: 20-09-25