Diagnosis and management of subarachnoid haemorrhage

被引:32
作者
Thilak, Suneesh [1 ]
Brown, Poppy [1 ]
Whitehouse, Tony [1 ,2 ]
Gautam, Nandan [1 ]
Lawrence, Errin [1 ,2 ]
Ahmed, Zubair [2 ,3 ]
Veenith, Tonny [2 ,3 ,4 ]
机构
[1] Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp, Birmingham B15 2GW, England
[2] Univ Birmingham, Inst Inflammat & Ageing, Birmingham B15 2TT, England
[3] Univ Birmingham, Ctr Trauma Sci Res, Birmingham B15 2TT, England
[4] New Cross Hosp, Royal Wolverhampton NHS Fdn Trust, Dept Crit Care Med & Anaesthesia, Wolverhampton WV10 0QP, England
关键词
DELAYED CEREBRAL-ISCHEMIA; RUPTURED INTRACRANIAL ANEURYSMS; ROW CT ANGIOGRAPHY; BRAIN-INJURY; MEDICAL COMPLICATIONS; ENDOVASCULAR COILING; MAGNESIUM-SULFATE; BLOOD-FLOW; VASOSPASM; IMPACT;
D O I
10.1038/s41467-024-46015-2
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Aneurysmal subarachnoid haemorrhage (aSAH) presents a challenge to clinicians because of its multisystem effects. Advancements in computed tomography (CT), endovascular treatments, and neurocritical care have contributed to declining mortality rates. The critical care of aSAH prioritises cerebral perfusion, early aneurysm securement, and the prevention of secondary brain injury and systemic complications. Early interventions to mitigate cardiopulmonary complications, dyselectrolytemia and treatment of culprit aneurysm require a multidisciplinary approach. Standardised neurological assessments, transcranial doppler (TCD), and advanced imaging, along with hypertensive and invasive therapies, are vital in reducing delayed cerebral ischemia and poor outcomes. Health care disparities, particularly in the resource allocation for SAH treatment, affect outcomes significantly, with telemedicine and novel technologies proposed to address this health inequalities. This article underscores the necessity for comprehensive multidisciplinary care and the urgent need for large-scale studies to validate standardised treatment protocols for improved SAH outcomes. Aneurysmal subarachnoid haemorrhage, with its multisystem effects, presents a substantial challenge to clinicians. Here, the authors show the necessity for comprehensive multidisciplinary care and the urgent need for largescale studies to validate standardised treatment protocols for improved outcomes.
引用
收藏
页数:11
相关论文
共 144 条
  • [1] Incidence and clinical characteristics of takotsubo cardiomyopathy post-aneurysmal subarachnoid hemorrhage
    Abd, Thura T.
    Hayek, Salim
    Cheng, Jeh-wei
    Samuels, Owen B.
    Wittstein, Ilan S.
    Lerakis, Stamatios
    [J]. INTERNATIONAL JOURNAL OF CARDIOLOGY, 2014, 176 (03) : 1362 - 1364
  • [2] Negative CT Angiography Findings in Patients with Spontaneous Subarachnoid Hemorrhage: When Is Digital Subtraction Angiography Still Needed?
    Agid, R.
    Andersson, T.
    Almqvist, H.
    Willinsky, R. A.
    Lee, S. -K.
    TerBrugge, K. G.
    Farb, R. I.
    Soderman, M.
    [J]. AMERICAN JOURNAL OF NEURORADIOLOGY, 2010, 31 (04) : 696 - 705
  • [3] CEREBRAL ARTERIAL SPASM - A CONTROLLED TRIAL OF NIMODIPINE IN PATIENTS WITH SUBARACHNOID HEMORRHAGE
    ALLEN, GS
    AHN, HS
    PREZIOSI, TJ
    BATTYE, R
    BOONE, SC
    CHOU, SN
    KELLY, DL
    WEIR, BK
    CRABBE, RA
    LAVIK, PJ
    ROSENBLOOM, SB
    DORSEY, FC
    INGRAM, CR
    MELLITS, DE
    BERTSCH, LA
    BOISVERT, DPJ
    HUNDLEY, MB
    JOHNSON, RK
    STROM, JA
    TRANSOU, CR
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1983, 308 (11) : 619 - 624
  • [4] Barriers and Facilitators That Influence Telemedicine-Based, Real-Time, Online Consultation at Patients' Homes: Systematic Literature Review
    Almathami, Hassan Khader Y.
    Win, Khin Than
    Vlahu-Gjorgievska, Elena
    [J]. JOURNAL OF MEDICAL INTERNET RESEARCH, 2020, 22 (02)
  • [5] Intravascular Inflammation Triggers Intracerebral Activated Microglia and Contributes to Secondary Brain Injury After Experimental Subarachnoid Hemorrhage (eSAH)
    Atangana, Etienne
    Schneider, Ulf C.
    Blecharz, Kinga
    Magrini, Salima
    Wagner, Josephin
    Nieminen-Kelha, Melina
    Kremenetskaia, Irina
    Heppner, Frank L.
    Engelhardt, Britta
    Vajkoczy, Peter
    [J]. TRANSLATIONAL STROKE RESEARCH, 2017, 8 (02) : 144 - 156
  • [6] Anemia After Aneurysmal Subarachnoid Hemorrhage Is Associated With Poor Outcome and Death
    Ayling, Oliver G. S.
    Ibrahim, George M.
    Alotaibi, Naif M.
    Gooderham, Peter A.
    Macdonald, R. Loch
    [J]. STROKE, 2018, 49 (08) : 1859 - 1865
  • [7] Serum glutamine and hospital-acquired infections after aneurysmal subarachnoid hemorrhage
    Badjatia, Neeraj
    Cremers, Serge
    Claassen, Jan
    Connolly, E. Sander
    Mayer, Stephan A.
    Karmally, Wahida
    Seres, David
    [J]. NEUROLOGY, 2018, 91 (05) : E421 - E426
  • [8] Impact of Induced Normothermia on Outcome After Subarachnoid Hemorrhage: A Case-Control Study
    Badjatia, Neeraj
    Fernandez, Luis
    Schmidt, J. Michael
    Lee, Kiwon
    Claassen, Jan
    Connolly, E. Sander
    Mayer, Stephan A.
    [J]. NEUROSURGERY, 2010, 66 (04) : 696 - 701
  • [9] Prospective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage
    Banki, Nader
    Kopelnik, Alexander
    Tung, Poyee
    Lawton, Michael T.
    Gress, Daryl
    Drew, Barbara
    Dae, Michael
    Foster, Elyse
    Parmley, William
    Zaroff, Jonathan
    [J]. JOURNAL OF NEUROSURGERY, 2006, 105 (01) : 15 - 20
  • [10] Acute neurocardiogenic injury after subarachnoid hemorrhage
    Banki, NM
    Kopelnik, A
    Dae, MW
    Miss, J
    Tung, P
    Lawton, MT
    Drew, BJ
    Foster, E
    Smith, W
    Parmley, WW
    Zaroff, JG
    [J]. CIRCULATION, 2005, 112 (21) : 3314 - 3319