At the time of onset, it has the following characteristics:
1) Features of cerebral vasospasm dizziness: dizziness is persistent or paroxysmal.
2) Characteristics of cerebral vasospasm headache: persistent headache, dull pain in the head, feeling of oppression and heaviness, and some patients complained of "tightening" in the head.
The prevention and treatment principles of cerebral vasospasm should include four aspects: etiology treatment, prevention first, whole course treatment and prevention and treatment of complications.
Drug therapy: 1) calcium antagonist;
2) Magnesium agent (magnesium sulfate, which has a certain preventive and therapeutic effect on cerebral vasospasm)
3) Papaverine (Papaverine is a vasodilator, which can act on spasmodic arteries with high selectivity when applied locally, but the disadvantage is that the action time is short and the vasodilator effect on elderly patients is reduced).
4) Other drugs (such as fasudil)
At present, nimodipine and fasudil hydrochloride are commonly used drugs.
The treatment principle of subarachnoid hemorrhage is: stop continuous bleeding, prevent and treat secondary cerebral vasospasm, reduce intracranial pressure, relieve brain edema, eliminate the cause, prevent and treat rebleeding and various serious complications.
First, general treatment and symptomatic treatment:
1. Absolute bed rest: The patient should be hospitalized and stay in bed for 4 ~ 6 weeks (avoid all possible causes of high blood pressure or intracranial pressure, such as forced defecation, cough, sneezing, emotional excitement, fatigue, etc. ).
2. Sedation and analgesia: those with headache, irritability and mental symptoms can be given appropriate sedative and analgesic drugs to avoid using drugs that affect breathing and consciousness observation.
3. Adjust blood pressure: Adjust blood pressure appropriately. In patients with normal blood pressure in the past, blood pressure increased after SAH, and the blood pressure was controlled near the normal level; For people with hypertension in the past, control blood pressure close to the usual blood pressure level. Generally, the systolic blood pressure should not be higher than150 ~150 ~180mmhg.
4. Anticonvulsion: Epilepsy authors can give phenytoin sodium, carbamazepine, valproate sodium, diazepam and other antiepileptic drugs.
5. Correct hyponatremia: When hyponatremia exists, isotonic fluid should be given. When blood volume is insufficient, fluid replacement should be done in time to avoid using hypotonic fluid.