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Early management of the patient with recent aneurysmal subarachnoid hemorrhage
Journal article   Open access   Peer reviewed

Early management of the patient with recent aneurysmal subarachnoid hemorrhage

H P Adams Jr
Stroke (1970), Vol.17(6), pp.1068-1070
11/1986
DOI: 10.1161/01.str.17.6.1068
PMID: 3810703
url
https://doi.org/10.1161/01.str.17.6.1068View
Published (Version of record) Open Access

Abstract

Despite its efficacy in preventing rebleeding, the anticipated strong trend in favor of early intracranial surgery has not been achieved. Early intracranial operation remains a useful choice in the management of recent SAH in good-risk patients, but patients must be carefully selected on an individual basis. Many patients will undoubtedly benefit from early surgery but it is not a panacea. Further investigation of surgical treatment in combination with improved preoperative and postoperative medical therapy will be required to ameliorate the outcome of SAH. In particular, the prevention and treatment of cerebral infarction deserves attention. The results of the antifibrinolytic and timing of intracranial surgery studies point to the need for an effective prevention treatment regimen for vasospasm. Further studies about the efficacy of calcium channel blocking drugs in prevention of ischemia after SAH are needed among patients given antifibrinolytic drugs or having early operation. All the advances in treatment are predicated on prompt diagnosis of SAH in good-condition patients. The medical community needs to maintain a high degree of vigilance for the diagnosis of SAH in all patients complaining of a new, unusual or severe headache. Early referral to properly equipped and staffed medical facilities remains a keystone to effective treatment of SAH.
Antifibrinolytic Agents - therapeutic use Intracranial Aneurysm - therapy Time Factors Subarachnoid Hemorrhage - therapy Humans Antihypertensive Agents - therapeutic use Intracranial Aneurysm - surgery

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