Watch for vasospasm and systemic complications after SAH rather than assuming the bleed is over once the aneurysm is secured. Secondary injury prevention is the focus here.

Individuals face high risks of acute rebleeding, hydrocephalus, delayed cerebral vasospasm, neurogenic cardiac complications, seizures, neurogenic pulmonary edema, and severe hyponatremia; It typically emerges between days 5 and 14, though about 50% of cases remain asymptomatic; Standard management includes inducing hypertension, maintaining hypervolemia, administering oral nimodipine, or pursuing endovascular balloon angioplasty; You will often see dramatic ECG changes, dangerous arrhythmias, and stress-induced myocardial injury, all driven by a massive systemic catecholamine surge; They occur in roughly 10% to 20% of cases, and are significantly more common if there is an associated parenchymal intracerebral hemorrhage