Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide

Aneurysmal subarachnoid hemorrhage (aSAH) is an emergency that needs prompt diagnosis and treatment with endovascular coiling or surgical clipping of the aneurysm to prevent re-bleeding. In addition to neurologic manifestations, aSAH can cause respiratory and cardiovascular complications. The preven...

Full description

Saved in:
Bibliographic Details
Published in:Turkish journal of anaesthesiology and reanimation 2023-06, Vol.51 (3), p.17-178
Main Authors: Özlem Korkmaz Dilmen, Bonhomme, Vincent
Format: Article
Language:English
Subjects:
Anesthesia & intensive care
Anesthesiology and Pain Medicine
Anesthésie & soins intensifs
Angioplasty
Brain ischemia
Emergency Medicine
General Earth and Planetary Sciences
General Environmental Science
Human health sciences
Hypoxemia
intracranial aneurysm
pulmonary edema
Review
Sciences de la santé humaine
Stroke
subarachnoid hemorrhage
vasospasm
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aneurysmal subarachnoid hemorrhage (aSAH) is an emergency that needs prompt diagnosis and treatment with endovascular coiling or surgical clipping of the aneurysm to prevent re-bleeding. In addition to neurologic manifestations, aSAH can cause respiratory and cardiovascular complications. The prevention of hypoxemia and hypercarbia, control of intracranial pressure, and restoration of cerebral perfusion pressure should be the primary aims of early management. Secondarily, the most important causes of persistent neurological deficits and physical dependence in aSAH are vasospasm and delayed ischemia following bleeding. During that period, a focus on the detection, prevention, and treatment of vasospasm should be the rule. Transcranial Doppler allows detection and follow-up of vasospasm, especially in severe cases. Nimodipine is the only drug that has proven efficacy for treating vasospasm. Balloon angioplasty is performed in cases of resistance to medical treatment. Along with angioplasty, intra-arterial vasodilators can be administered. New diagnostic and therapeutic advances will hopefully improve outcomes in the near future.
ISSN:2667-677X
2667-6370
2667-6370
DOI:10.4274/TJAR.2023.231205