Spontaneous nontraumatic subarachnoid hemorrhage without cerebrovascular malformations in a maintenance hemodialysis patient

R Jayasurya; N Murugesan; R Kumar; AK Dubey; PS Priyamvada; RP Swaminathan; S Parameswaran

doi:10.4103/0971-4065.156909

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CASE REPORT

Year : 2015 | Volume : 25 | Issue : 5 | Page : 310-314

Spontaneous nontraumatic subarachnoid hemorrhage without cerebrovascular malformations in a maintenance hemodialysis patient

R Jayasurya¹, N Murugesan², R Kumar³, AK Dubey¹, PS Priyamvada¹, RP Swaminathan⁴, S Parameswaran¹
¹ Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
² Department of Nephrology, East Coast Hospital, Moolakulam, Puducherry, India
³ Department of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
⁴ Department of General Medicine and Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Correspondence Address:
S Parameswaran
Department of Nephrology, SS Block, Jawaharlal Institute of Postgraduate Medical Education and Research Campus, Dhanvantari Nagar P. O., Puducherry 605 006
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0971-4065.156909

Nontraumatic subarachnoid hemorrhage (SAH) in a dialysis patient is an uncommon occurrence and is often associated with high mortality. We report for the first time in India, a case of spontaneous nontraumatic, nonaneurysmal SAH without any cerebrovascular malformation in a maintenance hemodialysis patient, following a session of hemodialysis. The dialysis prescription needs to be modified in these patients, in order to prevent worsening of cerebral edema and progression of hemorrhage. Where available, continuous forms of renal replacement therapies, with regional anticoagulation seem to be the best option for such patients, till neurologic stabilization is achieved.

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