Had Aneurysm. Lots Of Hemmoraging In Brain. Suggest
 
                                    
                                    
                                                
                                                Mon, 27 May 2013
                                                
                                            
                                                Answered on
                                             
                                            
                                                
                                                Wed, 19 Jun 2013
                                                
                                                
                                                Last reviewed on
                                             
                                            Is there a specializing hospital in US that we could transfer him to that might impact a positive turn around in this condition?
Thank you for posting your query.
Aneurysm rupture leading to subarachnoid hemorrhage (SAH) is a serious condition, with high morbidity and mortality.
The treatment at this stage would be largely supportive, including medications such as nimodipine, adequate saline infusion through veins, keeping the BP on the higher side, and use of anti epileptic medications.
Other treatments would be good physiotherapy, prevention of chest infection and DVT in legs, adequate nutrition through naso gastric tube feeding, etc. In summary, a good ICU care is needed.
The above treatments can be provided in most hospitals, with a neurologist/neurosurgeon on board with a good neuro ICU facility.
The definitive treatment of aneurysm is clipping or coiling of the aneurysm to prevent recurrence of bleeding. This may be done in a hospital with expertise. The best hospitals for this in US include Johns XXXXXXX in Maryland, Baltimore, Mayo Clinic, Rochester, Minnesota and Massachusetts General Hospital, Boston.
At present, I do not think shifting the patient would make any significant difference. However, you can get in tough with one of the hospitals regarding the definitive treatment of aneurysm once the patient is fit for that.
I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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