Modelo de conservación de levine en el cuidado del paciente con hemorragia subaracnoidea aneurismática fisher grado iv

Abstract

Introduction: Aneurysmal Subarachnoid Hemorrhage is a life-threatening event and is associated with poor outcomes in many patients. Its main cause is the rupture of a cerebral aneurysm and it occurs in an average of 80 to 85%. In 2016, the Ministry of Public Health reported 521 deaths due to this disease, 18 of them corresponded to the Province of El Oro, and almost half of these deaths originated in Machala. Regarding the clinical manifestations, headache is the characteristic symptom, followed by nausea and vomiting, changes in consciousness, neck stiffness, and temporary loss of consciousness. The risk factors that predominate in this pathology are: hypertension and smoking, followed by advanced age, surgery lasting more than one hour, a known history of ischemic heart disease, intraoperative bleeding of more than 500 ml. Other independent factors for aneurysmal rebleeding include: gender, high Fisher grade,> 10 mm in aneurysm size, and poor clinical condition. Advances in medical and neurosurgical treatment have improved mortality rates in these patients. Among the complications that may occur are: neurological, respiratory, nutritional - metabolic, cardiovascular and infectious.