Controversies in the management of aneurysmal subarachnoid hemorrhage

Neeraj S. Naval, Robert D. Stevens, Marek A. Mirski, Anish Bhardwaj

Research output: Contribution to journalReview article

67 Scopus citations

Abstract

Background: The care of patients with aneurysmal subarachnoid hemorrhage has evolved significantly with the advent of new diagnostic and therapeutic modalities. Although it is believed that these advances have contributed to improved outcomes, considerable uncertainty persists regarding key areas of management. Objective: To review selected controversies in the management of aneurysmal subarachnoid hemorrhage, with a special emphasis on endovascular vs. surgical techniques for securing aneurysms, the diagnosis and therapy of cerebral vasospasm, neuroprotection, antithrombotic and anticonvulsant agents, cerebral salt wasting, and myocardial dysfunction, and to suggest venues for further clinical investigation. Data Source: Search of MEDLINE and Cochrane databases and manual review of article bibliographies. Data Synthesis and Conclusions: Many aspects of care in patients with aneurysmal subarachnoid hemorrhage remain highly controversial and warrant further resolution with hypothesis-driven clinical or translational research. It is anticipated that the rigorous evaluation and implementation of such data will provide a basis for improvements in short- and long-term outcomes.

Original languageEnglish (US)
Pages (from-to)511-524
Number of pages14
JournalCritical care medicine
Volume34
Issue number2
DOIs
StatePublished - Feb 2006
Externally publishedYes

Keywords

  • Aneurysm
  • Hemorrhage
  • Ischemia
  • Subarachnoid
  • Vasospasm

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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