Which of the following is a potential complication of subarachnoid hemorrhage to monitor and manage?

• A. Hydrocephalus
• B. Hyperglycemia
• C. Peripheral edema
• D. Dehydration

Answer: (A)

Hydrocephalus after a subarachnoid hemorrhage occurs because blood in the subarachnoid space can block CSF flow and impair absorption at the arachnoid granulations. That obstruction lets CSF build up in the ventricles, increasing intracranial pressure and risking brain injury. Because of this, it’s a major complication to monitor and manage in the SAH patient.

Clinically, watch for signs of rising ICP and hydrocephalus such as a declining level of consciousness, new or worsening headaches, nausea or vomiting, papilledema, changes in pupil response, or new focal neurologic changes. Management involves close neurologic checks and serial imaging (usually CT scans) to track ventricular size and brain edema. If ICP rises or hydrocephalus is confirmed, options include placing an external ventricular drain to drain CSF or, if needed long-term, a ventriculoperitoneal shunt. Also, addressing SAH itself with appropriate blood pressure control and therapies to prevent vasospasm is important, because vasospasm can compound brain injury after SAH.

Other options like hyperglycemia, peripheral edema, or dehydration are not direct SAH-specific complications that require the same level of targeted monitoring and management as hydrocephalus.