Nursing care and treatment of cerebral vasospasm following subarachnoid haemorrhage - Essay Example

Cerebral vasospasm is one of the devastating complications following subarachnoid hemorrhage and is associated with high mortality.Despite extensive study and research,the pathogenesis and pathophysiology of this complication remains poorly understood Despite extensive study and research, the pathogenesis and pathophysiology of this complication remains poorly understood. Because of this, medical treatment of this condition is largely limited to calcium channel blockers, triple-H therapy and the most recent papaverine infusion and percutaneous transluminal angioplasty.

More often than not, clinical signs and symptoms of cerebral vasospasm are first recognised by a nurse, who then alerts the physician. Thus, nurses caring for patients with subarachnoid hemorrhage must be aware of cerebral vasospasm and the necessary steps that must be taken after detecting the condition (Kosty, 2005). Also, treatments for vasospasm are at risk of several complications which must be monitored by the care taking nurse closely. Thus, nurses play a very important role in the recognition and management of cerebral vasospasm following subarachnoid hemorrhage (Campbell, 1997).

In this review, critical analysis of nursing management of cerebral vasospasm will be done. Aims The aims of the review are to critically analyse and evaluate treatment of cerebral vasospasm secondary to subarachnoid hemorrhage through a nursing perspective. Objectives . There are several causes for subarachnoid hemorrhage, the most common cause being pre-existing aneurysm. Subarachnoid hemorrhage due to aneurysm is not preventable because; it is very difficult to detect aneurysms that are unruptured (Kosty, 2005).

Aneurysms are lesions that are acquired on the arterial walls because of hemodynamic stress. They usually occur over bends and points of bifurcation. There are several types of aneurysms, those which occur in intracranial arteries are saccular and berry aneurysms (Kosty, 2005). This is because; intracranial arteries do not have external elastic lamina and have adventia that is very thin. Both these predispose to aneurysms. Another factor that makes intracranial arteries vulnerable to aneurysms is the fact that they lie in the subarachnoid space without any support.

Aneurysms mainly occur in the internal carotid artery's terminal portion and also from the branches arises from the anterior aspect of the circle of Willis (Becske, and Jallo, 2010). The estimated prevalence of subarachnoid hemorrhage in populations all over the world is 0.3- 5 percent (Becske, and Jallo, 2010). The incidence is slightly more in women than in men. The mean age of this emergency is around 50 years (Becske, and Jallo, 2010). The mortality associated with this condition is very high.

60 percent of the patients die within 30 days following the hemorrhage (Becske, and Jallo, 2010). Of these, 10 percent die without any warning (Becske, and Jallo, 2010). 30 percent of patients die within the first 2 weeks (Kosty, 2005) and 15 percent of the patients develop severe disability (Kosty, 2005). Only less than 30 percent patients have moderate or good recovery (Kosty, 2005). Other than mortality, sub-arachnoid hemorrhage also leads to