Aneurysmal Subarachnoid Hemorrhage and Vasospasm

AACN Adv Crit Care. 2018 Summer;29(2):163-174. doi: 10.4037/aacnacc2018491.

Abstract

Aneurysmal subarachnoid hemorrhage is potentially fatal and is associated with poor outcomes in many patients. Advances in neurosurgical and medical management of ruptured aneurysms have improved mortality rates in patients with aneurysmal subarachnoid hemorrhage. Surgical and endovascular interventions, such as external ventricular drain placement, aneurysm clipping, and endovascular coiling, have been developed over the past few decades. Patients with aneurysmal subarachnoid hemorrhage are also at risk for cerebral vasospasm and delayed cerebral ischemia. This article describes the diagnosis and treatment of aneurysmal subarachnoid hemorrhage, vasospasm, and cerebral ischemia. Concurrent medical considerations and ideas for future neuroinflammatory vasospasm research are also discussed.

Keywords: aneurysm; aneurysm clipping; delayed cerebral ischemia; endovascular coiling; endovascular intervention; subarachnoid hemorrhage; vasospasm.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / surgery*
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / surgery*
  • Cerebral Revascularization / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / standards*
  • Practice Guidelines as Topic*
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / surgery*
  • Vasospasm, Intracranial / diagnosis
  • Vasospasm, Intracranial / surgery*