Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-19T08:43:18.762Z Has data issue: false hasContentIssue false

Chapter 13 - Subarachnoid Hemorrhage

Published online by Cambridge University Press:  28 October 2019

Mary Carter Denny ,
Ahmad Riad Ramadan ,
Sean I. Savitz  and
James Grotta
Mary Carter Denny
Affiliation:
Georgetown University Hospital
Ahmad Riad Ramadan
Affiliation:
Henry Ford Hospital, Detroit
Sean I. Savitz
Affiliation:
University of Texas Health Science Center, Houston
James Grotta
Affiliation:
Memorial Hermann Texas Medical School
Get access

Summary

This chapter covers the diagnosis and management of spontaneous subarachnoid hemorrhage due to rupture of intracranial aneurysms. At the end of the chapter we also discuss unruptured intracranial aneurysms. Much SAH management is not based on good-quality evidence. Much of what is recommended here comes from published practice guidelines and what is commonly practiced. Options for therapy might be limited by the availability and experience of persons performing surgery, endovascular therapy, and neurointensive care.

Type
Chapter
Information
Acute Stroke Care , pp. 198 - 214
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Connolly, ES, Rabinstein, AA, Carhuapoma, JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012; 43: 1711–1737.Google Scholar
Labovitz, DL, Halim, AX, Brent, B, et al. Subarachnoid hemorrhage incidence among Whites, Blacks and Caribbean Hispanics: the Northern Manhattan Study. Neuroepidemiology 2006; 26: 147–150.Google Scholar
Suarez, JI, Tarr, RW, Selman, WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med 2006; 354: 387–396.Google Scholar
Darkwah Oppong, M, Gümüs, M, Pierscianek, D, et al. Aneurysm rebleeding before therapy: a predictable disaster? J Neurosurg 2018. doi:10.3171/2018.7.JNS181119. [Epub ahead of print]Google Scholar
Molyneux, A, Kerr, R, Stratton, I, et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 2002; 360: 1267–1274.Google Scholar
Lawton, MT, Vates, GE. Subarachnoid hemorrhage. N Engl J Med 2017; 377: 257–266.CrossRefGoogle ScholarPubMed
Petruk, KC, West, M, Mohr, G, et al. Nimodipine treatment in poor-grade aneurysm patients: results of a multicenter double-blind placebo-controlled trial. J Neurosurg 1988; 68: 505–517.Google Scholar
van der Jagt, M. Fluid management of the neurological patient: a concise review. Crit Care 2016; 20: 126.CrossRefGoogle Scholar
van den Bergh, WM, Algra, A, van Kooten, F, et al. Magnesium sulfate in aneurysmal subarachnoid hemorrhage: a randomized controlled trial. Stroke 2005; 36: 1011–1015.CrossRefGoogle ScholarPubMed
Kirkpatrick, PJ, Turner, CL, Smith, C, Hutchinson, PJ, Murray, GD;STASH Collaborators. Simvastatin in aneurysmal subarachnoid haemorrhage (STASH): a multicentre randomised phase 3 trial. Lancet Neurol 2014; 13: 666–675.Google Scholar
Muench, E, Horn, P, Bauhuf, C, et al. Effects of hypervolemia and hypertension on regional cerebral blood flow, intracranial pressure, and brain tissue oxygenation after subarachnoid hemorrhage. Crit Care Med 2007; 35: 1844–1851.CrossRefGoogle ScholarPubMed
Truelsen, T, Bonita, R, Duncan, J, Anderson, NE, Mee, E. Changes in subarachnoid hemorrhage mortality, incidence, and case fatality in New Zealand between 1981–1983 and 1991–1993. Stroke 1998; 29: 2298–2303.Google Scholar
Lantigua, H, Ortega-Gutierrez, S, Schmidt, JM, et al. Subarachnoid hemorrhage: who dies, and why? Crit Care 2015; 19: 309.Google Scholar
Longstreth, WT, Nelson, LM, Koepsell, TD, van Belle, G. Clinical course of spontaneous subarachnoid hemorrhage: a population-based study in King County, Washington. Neurology 1993; 43: 712–718.Google Scholar
Kassell, NF, Torner, JC, Jane, JA, Haley, EC, Adams, HP. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: surgical results. J Neurosurg 1990; 73: 37–47.Google Scholar
International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: risk of rupture and risks of surgical intervention. N Engl J Med 1998; 339: 1725–1733.Google Scholar
Wiebers, DO, Whisnant, JP, Huston, J, et al.; International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003; 362: 103–110.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×