A patient with aneurysmal SAH is awake, BP 202/108 mmHg and has no hydrocephalus. Neurosurgery is arranging aneurysm securing. Which early medical

Question

A patient with aneurysmal SAH is awake, BP 202/108 mmHg and has no hydrocephalus. Neurosurgery is arranging aneurysm securing. Which early medical plan is most appropriate?

Accepted Answer

Control BP and start nimodipine while expediting definitive aneurysm treatment

Answer

Give aspirin and therapeutic heparin to prevent aneurysm thrombosis before transfer

Answer

Allow unrestricted hypertension until clipping because lowering BP always worsens cerebral perfusion

Answer

Delay nimodipine until vasospasm is demonstrated by transcranial Doppler

Answer

Give large hypotonic fluid boluses to reduce serum sodium and cerebral oxygen demand

Calcium channel blocker overdose — RCPSC EM MCQ

A patient with aneurysmal SAH is awake, BP 202/108 mmHg and has no hydrocephalus. Neurosurgery is arranging aneurysm securing. Which early medical plan is most appropriate?