![](/images/graphics-bg.png)
Management of Agitation Following Aneurysmal Subarachnoid Hemorrhage : Is There a Role for Beta-Blockers?
Joint Authors
Viswanathan, Ramaswamy
Ibrahim, Fayaz
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-05-17
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
Introduction.
Stroke is a leading cause of mortality and morbidity in the United States.
About 20% of the stroke is hemorrhagic and about 50% of these is due to aneurysmal subarachnoid hemorrhage.
A troublesome neuropsychiatric complication of subarachnoid hemorrhage is agitation/aggression.
Case Presentation.
A 45-year-old man with no prior psychiatric history, sustained subarachnoid hemorrhage.
After initial stabilization for 2 days, he underwent craniotomy and clipping of anterior cerebral communicating artery aneurysm.
Treatment was continued with labetalol, nimodipine, and levetiracetam.
Beginning postoperative day 4, patient developed episodes of confusion and agitation/aggression.
Switching of Levetiracetam to valproate did not show any improvement.
Psychiatry team tried to manage him with intense nursing intervention and different medications like olanzapine, valproate, lorazepam, and haloperidol.
However, patient continued to be agitated and aggressive.
Switching from labetalol to metoprolol resulted in dramatic improvement within 3 days.
Discussion.
Antipsychotics and benzodiazepines are often not sufficiently effective in the control of agitation/aggression in patients with traumatic brain injury and similar conditions.
Our case report and the literature review including a cochrane review suggests that beta-blockers may be helpful in this situation.
American Psychological Association (APA)
Ibrahim, Fayaz& Viswanathan, Ramaswamy. 2012. Management of Agitation Following Aneurysmal Subarachnoid Hemorrhage : Is There a Role for Beta-Blockers?. Case Reports in Psychiatry،Vol. 2012, no. 2012, pp.1-3.
https://search.emarefa.net/detail/BIM-496098
Modern Language Association (MLA)
Ibrahim, Fayaz& Viswanathan, Ramaswamy. Management of Agitation Following Aneurysmal Subarachnoid Hemorrhage : Is There a Role for Beta-Blockers?. Case Reports in Psychiatry No. 2012 (2012), pp.1-3.
https://search.emarefa.net/detail/BIM-496098
American Medical Association (AMA)
Ibrahim, Fayaz& Viswanathan, Ramaswamy. Management of Agitation Following Aneurysmal Subarachnoid Hemorrhage : Is There a Role for Beta-Blockers?. Case Reports in Psychiatry. 2012. Vol. 2012, no. 2012, pp.1-3.
https://search.emarefa.net/detail/BIM-496098
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-496098