Survival of a subarachnoid hemorrhage patient who presented with prehospital cardiopulmonary arrest: case report and review of the literature.
A 63-year-old woman was admitted to the intensive care unit after resuscitation from prehospital cardiopulmonary arrest (CPA). A brain CT scan revealed a subarachnoid hemorrhage (SAH), which was considered to be the cause of the CPA. The patient recovered neurologically after admission, and the elevated intracranial pressure (ICP) was controlled by inducing mild hypothermia. The day after admission, cerebral angiography revealed a ruptured cerebral aneurysm. The aneurysm was successfully treated with detachable coils by an endovascular technique. Mild hypothermia was continued for 3 days, and the patient was gradually rewarmed. After rehabilitation, the patient was discharged to her home with severe disability. Although aneurysmal SAH is one of the most common causes of CPA, survival of SAH patients after CPA is rare. This case illustrates the ability and possibility of multidisciplinary treatment, including the use of endovascular techniques and mild hypothermia, to improve the outcome of SAH patients with CPA who have been considered to be inoperable and untreatable.
Inamasu
J
J
Department of Neurosurgery, National Tokyo Medical Center, Higashigaoka 2-5-1, Meguro-ku, Tokyo 152-8902, Japan. georges@med.keio.ac.jp
Saito
R
R
Nakamura
Y
Y
Ichikizaki
K
K
Suga
S
S
Kawase
T
T
Hori
S
S
Aikawa
N
N
D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome