TY - JOUR
T1 - How we do it
T2 - Acute management of subarachnoid hemorrhage
AU - Burrows, Antony M.
AU - Korumilli, Ritesh
AU - Lanzino, Giuseppe
PY - 2013/3
Y1 - 2013/3
N2 - Objectives: Acute subarachnoid hemorrhage (SAH) is a neurological emergency with significant potential for long-term morbidity and mortality. We review our management of acute SAH and some of the evidence base supporting our practices. Methods: We reviewed our standardized and multi-disciplinary approach to the management of SAH. Results: Management of SAH treatment can be divided into acute, aneurysmal, waiting, and post-waiting phases. Acute issues upon presentation include hemodynamic and respiratory stability, prevention of rebleeding, and treatment of hydrocephalus. The aneurysm must then be secured through endovascular or microsurgical methods. Observation for signs and symptoms of vasospasm must be closely undertaken. Prevention of subsequent medical complications must also be undertaken. Weaning from cerebrospinal fluid diversion and possible shunting is the final step. Discussion: Standardized multi-modality management of rebleeding, hydrocephalus, aneurysmal obliteration, vasospasm, cerebral salt wasting, and other medical complications during these phases, is critical.
AB - Objectives: Acute subarachnoid hemorrhage (SAH) is a neurological emergency with significant potential for long-term morbidity and mortality. We review our management of acute SAH and some of the evidence base supporting our practices. Methods: We reviewed our standardized and multi-disciplinary approach to the management of SAH. Results: Management of SAH treatment can be divided into acute, aneurysmal, waiting, and post-waiting phases. Acute issues upon presentation include hemodynamic and respiratory stability, prevention of rebleeding, and treatment of hydrocephalus. The aneurysm must then be secured through endovascular or microsurgical methods. Observation for signs and symptoms of vasospasm must be closely undertaken. Prevention of subsequent medical complications must also be undertaken. Weaning from cerebrospinal fluid diversion and possible shunting is the final step. Discussion: Standardized multi-modality management of rebleeding, hydrocephalus, aneurysmal obliteration, vasospasm, cerebral salt wasting, and other medical complications during these phases, is critical.
KW - Neurocritical care
KW - Neurosurgery
KW - Subarachnoid hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=84874620913&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874620913&partnerID=8YFLogxK
U2 - 10.1179/1743132812Y.0000000124
DO - 10.1179/1743132812Y.0000000124
M3 - Article
C2 - 23452572
AN - SCOPUS:84874620913
SN - 0161-6412
VL - 35
SP - 111
EP - 116
JO - Neurological research
JF - Neurological research
IS - 2
ER -