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학습 자료 둘러보기 →The sudden onset of severe headache, sensitivity to light, and neck stiffness within 24 hours of aneurysm clipping signals a likely re-bleed or severe vasospasm. The first priority is to optimize cerebral hemodynamics.
Immediately position the patient in semi-Fowler's (15-30 degrees) with the head in strict neutral alignment. This promotes cerebral venous outflow and prevents jugular vein compression, directly helping to lower intracranial pressure (ICP).
Do not administer analgesics as a first action, as they can mask the neurological exam. Avoid increasing IV fluids rapidly, which may raise blood pressure and worsen bleeding. Activities that increase intrathoracic pressure, like deep breathing exercises, can further elevate ICP.
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