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Had aneurysm. Lots of hemmoraging in brain. Suggest

Nov 2013
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Question regarding Aneurysm: The condition looks grim, the aneurysm occured last Wednesday. Patient had/has lots of hemmoraging in brain -- no substantial brain waves.
Is there a specializing hospital in US that we could transfer him to that might impact a positive turn around in this condition?
Posted Mon, 17 Jun 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 1 hour later

Thank you for posting your query.

Aneurysm rupture leading to subarachnoid hemorrhage (SAH) is a serious condition, with high morbidity and mortality.
The treatment at this stage would be largely supportive, including medications such as nimodipine, adequate saline infusion through veins, keeping the BP on the higher side, and use of anti epileptic medications.

Other treatments would be good physiotherapy, prevention of chest infection and DVT in legs, adequate nutrition through naso gastric tube feeding, etc. In summary, a good ICU care is needed.

The above treatments can be provided in most hospitals, with a neurologist/neurosurgeon on board with a good neuro ICU facility.

The definitive treatment of aneurysm is clipping or coiling of the aneurysm to prevent recurrence of bleeding. This may be done in a hospital with expertise. The best hospitals for this in US include Johns XXXXXXX in Maryland, Baltimore, Mayo Clinic, Rochester, Minnesota and Massachusetts General Hospital, Boston.

At present, I do not think shifting the patient would make any significant difference. However, you can get in tough with one of the hospitals regarding the definitive treatment of aneurysm once the patient is fit for that.

I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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