savingthebrain

Hi Sally, BP readings come with 2 numbers as bob said: -- the top number is the systolic pressure = the peak pressure when the heart is beating -- the bottom number is the diastolic pressure = the pressure when the heart relaxes Both are important. If the pressure in the arteries is too high , they can rupture and cause a bleed. High diastolic pressures are bad too because it means you have sustained pressures in your blood vessels and will make your heart pump harder. BP varies from person to person. For some, a BP of 130/90 is high for them and they start feeling symptoms. For others, 180/90 is nothing. For persons at risk for bleeding/rupture, we in the ICU generally want to keep systolic BPs less than 140.

Gill, Bleeding into the brain tissue or into the ventricles (such as in the case of a ruptured aneurysm) should show in the CT -- unless it is a very, very small bleed. If the bleed is new and the doctors want to determine if it progresses, they may order a repeat CT scan after a few hours. Non-contrast CTs will not give you a good picture of blood vessels, however. It will not detect aneurysms that haven't ruptured, as these are blood vessels (arteries). To view blood vessels, you need a CT angiography. Or better yet, a 4-vessel angiography. And of course, MRIs are the best. But they take longer to schedule and are expensive!

Thanks for the info, Sonia. I certainly learned something from you today. Gee, I know someone with same symptoms. Blepharospasm, especially when tired or after prolonged computer use. ... and she's been to eye doctors and had taken muscle relaxants. No one even told her what it's called... Hope everything turns out well for you.

For some reason, the doctors here usually ask: "Is this the worst headache of your life?" More often than not, a person with an acute bleed would say yes. But to be safe, if your gut says something is wrong, always push for a CT scan at the very least. A non-contrast CT is fast and doesn't need preparation. It may not clearly detect aneurysms but it'll tell you if there's blood in the brain or in the ventricles. Doctors should really practice pushing for CT scans, because unlike other organs that heal, brain tissue dies after 4-6 minutes without oxygen. Such a delicate, delicate organ... and one we can't take any chances with.

Cerebral vasospasms peak during the 5th-10th day after SAH. Patients usually stay in the ICU for up to 2 weeks. They're rare after 3 weeks, but can happen. If you have symptoms you definitely have to have yourself checked as vasospasms can cause a decrease in brain oxygenation. Report any unusual headache or change in mental status. Also, check for "drift."-- Raise both arms out (palms up) in front of you and close your eyes. If one of your arms drop after a few seconds, it can mean you're having vasospasms.

Agree with the rest, Diane. It may be nothing, but better safe than sorry. So a doctor's visit won't hurt. As for SAHs happening during your sleep... while a blood vessel rupture is likely to happen during times of increased pressure (stress, hypertensive episode), I have heard of people waking up with severe headaches. In short, they do happen, but probably less common. In the long run, aneurysms and blood vessels just rupture when they ****** feel like it (nasty little things)... But take it easy. Happy first anniversary to your hubby. Don't worry, people who've experienced things tend to be a little paranoid. So it's probably nothing.

Thanks for the lovely welcome, everyone. It's great that you can all find humor in your hospital experiences! Don't worry, we nurses know any brain condition "brings out the devil" in every person. Other than the constant pain, occasional nausea, and being confined in bed for days and days, people are, at best, irritable. At worst, some brains momentarily lose some functions, including inhibition, temperance, tact and reason. So we're used to patients pulling their lines out, jumping out of bed and yelling obscenities. And of course, almost everyone who's returned to thank us after discharge are actually really kind, thoughtful people. Smithy, I'm actually based in the US. A big wave to all you UK folks from across the Atlantic!

Gosh, I feel foolish for not seeing this thread and introducing myself in the "My Story" discussion. Anyway, here's what I wrote there: ---------- Unfortunately (or rather fortunately) I don't have a personal story to tell. Instead I'm a registered nurse working in a neuro ICU. We have a huge number of patients coming in for subarachnoid hemorrhage, and they stay with us for quite some time (usually 7-14 days) as we monitor them for cerebral vasospasms and other complications. As our docs have always reminded us, the fatality rate for SAH is 50% So for those of you who survived and lived to tell the tale, you beat the odds! Congratulations! ---------- It's so good to see how people do after everything's resolved! We get very sick patients, and the moment they're better, they leave the ICU, get transferred, and we rarely see how they are in the end. Stories and wonderful outcomes are always so humbling and invigorating!

Hello Lin-lin, Hope nothing is serious. Unfortunately shunts do malfunction at times - clogging, infection, wrong settings... so it isn't uncommon to have checks from time to time. Just make sure you are aware of signs that the shunt isn't working at its best -- change in neuro status, more drowsy, etc... I'm a nurse working in a neuro ICU and have seen many patients with unbelievably problematic hydrocephalus from the start... and even they worked out in the end. Best of luck!