Elevated intracranial pressure (ICP) is a well-recognized phenomenon in aneurysmal subarachnoid hemorrhage (aSAH) that has been demonstrated to lead to poor outcomes. Despite significant advances in clinical research into aSAH, there are no consensus guidelines devoted specifically to the management of elevated ICP in the setting of aSAH. To treat high ICP in aSAH, most centers extrapolate their treatment algorithms from studies and published guidelines for traumatic brain injury. Herein, the authors review the current management strategies for treating raised ICP within the aSAH population, emphasize key differences from the traumatic brain injury population, and highlight potential directions for future research in this controversial topic.
Keywords: CPP cerebral perfusion pressure; CSF = cerebrospinal fluid; DCI = delayed cerebral ischemia; EVD external ventricular drain; ICH = intracerebral hemorrhage; ICP; ICP = intracranial pressure; IVH = intraventricular hemorrhage; RCT = randomized controlled trial; TBI = traumatic brain injury; aSAH; aSAH = aneurysmal subarachnoid hemorrhage; aneurysm; intracranial pressure; management; subarachnoid hemorrhage.