The Problem of Recurrent Bleeding Within 24 Hours After Aneurysmal Subarachnoid Hemorrhage

Abstract

This is a report on recurrent bleeding within 24 hours after aneurysmal subarachnoid hemorrhage and is a part of our efforts to find the best procedure for dealing with subarachnoid hemorrhage in the acute phase.
Acute phase surgery was performed on 22 patients following hemorrhage. 5 cases (22.7%) showed recurrent bleeding prior to surgery. Recurrent bleeding occurred within 3.5 to 17 hours after the initial hemorrhage. Following recurrent bleeding, all patients suffered disturbances in consciousness, with 3 patients suffering convulsions. 3 patients suffered recurrent bleeding during transfer for the purpose of neuroradiological examination or surgery. No specific cause could be found for the other cases.
Patients with recurrent bleeding had higher rates of both mortality and morbidity than those not experiencing recurrent bleeding. It would appear that patients with recurrent bleeding need more sedation. Exercising optimum blood pressure control and keeping patients sedated during examinations, in particular during transfer, seem essential for the suitable management of aneurysmal subarachnoid hemorrhage within 24 hours after initial bleeding.