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 language | English (US) |
|---|---|
| Pages (from-to) | 511-524 |
| Number of pages | 14 |
| Journal | Critical Care Medicine |
| Volume | 34 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2006 |
| Externally published | Yes |
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Keywords
- Aneurysm
- Hemorrhage
- Ischemia
- Subarachnoid
- Vasospasm
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Controversies in the management of aneurysmal subarachnoid hemorrhage. / Naval, Neeraj S.; Stevens, Robert D.; Mirski, Marek A.; Bhardwaj, Anish.
In: Critical Care Medicine, Vol. 34, No. 2, 02.2006, p. 511-524.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Controversies in the management of aneurysmal subarachnoid hemorrhage
AU - Naval, Neeraj S.
AU - Stevens, Robert D.
AU - Mirski, Marek A.
AU - Bhardwaj, Anish
PY - 2006/2
Y1 - 2006/2
N2 - 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.
AB - 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.
KW - Aneurysm
KW - Hemorrhage
KW - Ischemia
KW - Subarachnoid
KW - Vasospasm
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U2 - 10.1097/01.CCM.0000198331.45998.85
DO - 10.1097/01.CCM.0000198331.45998.85
M3 - Article
VL - 34
SP - 511
EP - 524
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 2
ER -