SUBARACHNOID HEMORRHAGE : BRAIN HEART LUNG INTERACTION  : ABOUT 43 PATIENTS
A.NAILI, H.TRIKI, S.BOUDERRA
NEUROREANIMATION DEPARTEMENT –EPH SIDI GHILES- TIPAZA - ALGERIA

INTRODUCTION :
Subarachnoid hemorrhage is a neurovascular emergency mainly affecting the young subject, aneurysm rupture in 2% to 5%, but post traumatic most often. There may be a predisposing genetic terrain. Representing about 5% of strokes, the mortality-dependence associated with this pathology is of the order of 25%, cardiovascular and pulmonary complications have been reported in association with the occurrence of HSA. Mainly related to activation of the sympathetic system. The purpose of the study is to define the rate of cardiopulmonary complications that occurred in our department on meningeal hemorrhage.
PATIENTS AND METHOD :
it is a descriptive retrospective study of 329 patients admitted to our department who have meningeal hemorrhage over a period of one year 2016.  Data collected from patients' files
RESULTS :
329 patients admitted to our neurorejuvenation service for meningeal hemorrhage, 32% on aneurysm rupture, including two patients with a history of diabetes and chronic renal failure on polykystic kidney stage of dialysis, 16.1% post-traumatic brain injury, 6.9% postoperative intracranial surgery, 3% on arteriovenous malformation and 1.16% on brain tumor. Among 329, 43 patients had cardiopulmonary repercussions such as acute pulmonary edema in 53.3% and cardiac arrhythmias 12.5%, alterations in myocardial function with systolic and diastolic left heart failure in echocardiography in 36.7%, the troponorin level was strongly in 50% of the cases, the use of mechanical ventilation in 11.01%, catecholamines such as dobutamine in 39.89% of the cases with limitation of the vascular filling with control of the HIC and monitoring of the PIC, a regression of the table was noted in a few days, 09 patients died. As a result, in front of a cardiopulmonary distress table following hyperstimulation adrenergic and neurological inflammatory phenomena, the neurological, respiratory and haemodynamic resuscitation has priority
CONCLUSION :
Neurogenic cardiopulmonary complications appear to be a classically described but still unrecognized and under-diagnosed entity because the prevention and detection of non-neurological complications of cerebral aggression often remains secondary. Mortality is high but more related to neurological pathology than to pulmonary edema and cardiac dysfunction themselves. However, there are severe forms requiring early and adapted treatment and good knowledge of the pathophysiology of the causal mechanism.


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