Intensive care unit management of aneurysmal subarachnoid hemorrhage

Jennifer E. Fugate, Alejandro A. Rabinstein

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

The emergence of dedicated neurologic-neurosurgical intensive care units, advancements in endovascular therapies, and aggressive brain resuscitation and monitoring have contributed to overall improved outcomes for patients with aneurysmal subarachnoid hemorrhage (aSAH) over the past 20 to 30 years. Still, this feared neurologic emergency is associated with substantial mortality and morbidity. Emergency care for patients with aSAH focuses on stabilization, treatment of the aneurysm, controlling intracranial hypertension to optimize cerebral perfusion, and limiting secondary brain injury. This complex disorder can be associated with many neurologic complications such as acute hydrocephalus, rebleeding, global cerebral edema, seizures, vasospasm, and delayed cerebral ischemia in addition to systemic complications such as electrolyte imbalances, cardiopulmonary injury, and infections. Background routine intensive care practices such as avoidance of hyperthermia, venous thromboembolism prophylaxis, and avoidance of severe blood glucose derangements are additional important elements of care.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalCurrent neurology and neuroscience reports
Volume12
Issue number1
DOIs
StatePublished - Feb 1 2012

Keywords

  • Aneurysm
  • Cerebral edema
  • Delayed cerebral ischemia
  • Endovascular coiling
  • Hydrocephalus
  • Intensive care
  • Intracranial hemorrhage
  • Management
  • Neurocardiogenic injury
  • Neurocritical care
  • Neurogenic pulmonary edema
  • Subarachnoid hemorrhage
  • Surgical clipping
  • Vasospasm

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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