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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...

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Detalles Bibliográficos
Autores principales: Korkmaz Dilmen, Özlem, Bonhomme, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10339744/
https://www.ncbi.nlm.nih.gov/pubmed/37455434
http://dx.doi.org/10.4274/TJAR.2023.231205
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author Korkmaz Dilmen, Özlem
Bonhomme, Vincent
author_facet Korkmaz Dilmen, Özlem
Bonhomme, Vincent
author_sort Korkmaz Dilmen, Özlem
collection PubMed
description 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.
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spelling pubmed-103397442023-07-15 Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide Korkmaz Dilmen, Özlem Bonhomme, Vincent Turk J Anaesthesiol Reanim Review Article 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. Galenos Publishing 2023-06-16 /pmc/articles/PMC10339744/ /pubmed/37455434 http://dx.doi.org/10.4274/TJAR.2023.231205 Text en ©Copyright 2023 by the Turkish Anesthesiology and Reanimation Association / Turkish Journal of Anaesthesiology & Reanimation is published by Galenos Publishing House. https://creativecommons.org/licenses/by/4.0/Licensed under a Creative Commons Attribution (CC BY) 4.0 International License.
spellingShingle Review Article
Korkmaz Dilmen, Özlem
Bonhomme, Vincent
Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide
title Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide
title_full Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide
title_fullStr Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide
title_full_unstemmed Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide
title_short Management of Aneurysmal Subarachnoid Haemorrhage and its Complications: A Clinical Guide
title_sort management of aneurysmal subarachnoid haemorrhage and its complications: a clinical guide
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10339744/
https://www.ncbi.nlm.nih.gov/pubmed/37455434
http://dx.doi.org/10.4274/TJAR.2023.231205
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