Diagnosis and management of subarachnoid haemorrhage.
Suneesh ThilakPoppy BrownTony WhitehouseNandan GautamErrin LawrenceZubair AhmedTonny V VeenithPublished in: Nature communications (2024)
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.
Keyphrases
- brain injury
- healthcare
- cerebral ischemia
- subarachnoid hemorrhage
- computed tomography
- palliative care
- coronary artery
- risk factors
- public health
- blood pressure
- type diabetes
- combination therapy
- physical activity
- contrast enhanced
- metabolic syndrome
- pain management
- magnetic resonance
- cardiovascular disease
- adipose tissue
- social media
- chronic pain
- climate change
- dual energy
- image quality
- coronary artery disease
- smoking cessation
- fluorescence imaging