CLINICAL QUERIES: Systemic heparinization after subarachnoid hemorrhage
Wendi Rank MSN, RN, CNRN, CRNP

April 2012 
Volume 42  Number 4
Pages 66 - 66
  PDF Version Available!

Can you explain why I.V. heparin may be used in a patient with aneurysmal subarachnoid hemorrhage (SAH)? -J.E., N.H.Wendi Rank, MSN, RN, CNRN, CRNP, replies: SAH due to a ruptured cerebral aneurysm causes less than 10% of all strokes in the United States, but mortality can be as high as 50%. About half of all untreated, ruptured aneurysms hemorrhage again within 6 months. Patients who rebleed have a higher rate of death or disability.1For decades, the gold standard of treatment was neurosurgical clipping through open craniotomy, but not all aneurysms or patients with SAH were good candidates. Many patients with high acuity from the hemorrhage or comorbidities didn't tolerate the surgery well, and not all aneurysms can be easily accessed by surgery.2In the early 1990s, Guglielmi et al. proposed treating aneurysms endovascularly with platinum coils. Today, coils of various designs are placed directly into the aneurysm via a delivery wire threaded through an arterial catheter. Once placed,

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