In this insightful video, Dr. Amit Dhakoji, Head and Consultant Neurosurgeon at Manipal Hospital Pune, sheds light on ...

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Subarachnoid haemorrhage | Dr. Amit Dhakoji | Manipal Hospital Baner

hello everyone myself Dr amid dakui head and consultant neurosurgeon at manipal hospitals B Pune and today we are going to discuss a very crucial Neurosurgical emergency that is a subarid hemorage it falls under the category of hemorragic strokes and it is a particular type of hemorrage in the subarid system a system which is outside the brain and which surrounds the brain and it is filled with usually cereal spinal fluid or water around the brain so if any Hemorrhage occurs inside this compartment we call it as a subarachnoid hemorrage it is very common disorder usually during winter seasons or the earlier months of the year we encounter these sarid hemorrhages and the most common cause of these sarid hemorrhages is an aneurism so what is an aneurism aneurism is a balloon like dilation of a blood vessel inside the brain and it is because of the weakening of the vessel wall there can be multiple reasons for it it can be a genetic congenital weakness of the vessel wall it can be some inflamat disorders like Maran syndrome or rheumatoid arthritis or it could be related to increased sheer force that is hypertension so usually these are middle-aged males or female FES and they have sudden severe excruciating headache which they have never experienced in their life associated with neck pain so whenever any individual encounters such kind of severe excruciating headache which is unrelenting not responding to medicines sometimes they fall unconscious they can throw a seizure and when they land with us in the emergency department they we can find the neck is stiff and they are the patient is holding his head continuously occasionally there is vomiting also so we evaluate these patients with a CT scan which shows a typical pattern of sarak nard hemorrage and we know that some vessel balloon or an aneurism has ruptured inside the brain so to further investigate which vessel has ruptured and where it has ruptured how big is the aneurysm are there any other Associated aneurysms we to a CT angiography or a digital subtraction angiography so once we do these angiographies of the brain we know which vessel is harboring the aneurysm and depending upon the neck Dome ratio that is how short is the neck how is the Dome of the aneurism we need to treat either surgically or with an endovascular intervention so whenever one aneurysm has ruptured there is always a chance that it can rupture again because there is a potential rupture site already happening and once the blood pressure or any stress increases inside the patient's body body the site can give way again and there can be a potentially dangerous or potentially fatal subarchnoid hemorrage once again and usually the second hemorrage is very massive so to prevent this hemorrage again we have to treat this aneurysm as early as possible so usually we carry out the city angiography or digital subtraction angiography as early as possible and the next elective day or next day we usually like to treat this aneurysm so depending upon the site or depending upon the neck Dome ratio depending upon the nature of aneurysm either we can clip the aneurysm that means by opening the skull and we put a titanium clip across the neck to olude the aneurysm from the circulation or we can put an uh endovascular uh catheter and we can put coils inside the aneurism which can be a stent assisted coiling or without any assistance of stent so once we secure the aneurism and once we secure the neck of the aneurism the aneurysm is excluded from the brain circulation and no more any blood is going through the aneurysm so that these patients can be completely treated so uh this is a potentially fatal condition but if recognized early and if treated properly these patients are cured from in their lifetime so they will never develop aneurism at that site and they can lead a normal life so proper precaution like checking your blood pressure regularly after the age of 35 then uh avoid undue stress and to get yourself screened for angiography to rule out this uh aneurysms Whenever there is a family history of aneurysms in your family is very crucial for early identification and treatment of this potentially dangerous condition so we need a comprehensive team like a neurosurgeon a neurologist emergency medicine Department intensive care as well as neurovascular interventionist which is available at manipal hospital B Pune and I urge the general population to identify or be aware about this condition and uh we should give attention to this potentially dangerous condition called as aneurism of the brain and subarachnoid himage thank you so much [Music]

Dr.

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