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Treatment of Subarachnoid Hemorrhage in the Neurocritical Care Unit

  • Christopher M. Jackson
  • Justin M. Caplan
  • Judy Huang
  • Rafael J. TamargoEmail author
Chapter
  • 35 Downloads
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a neurological emergency with a high mortality rate in the acute period and a significant risk of mortality or permanent injury in the weeks following aneurysm rupture. In addition to neurologic injury, the systemic sequelae of aSAH impact multiple organ systems, confounding the treatment of vasospasm and delayed cerebral ischemia. Given the complexity of this disease process, aSAH patients should be cared for by multidisciplinary teams at high-volume centers in dedicated neurocritical care units. Although there is a paucity of high-quality evidence to guide management of aSAH, protocols that reflect the evolving risks these patients face in the hours, days, and weeks following aneurysm rupture can maximize the potential for neurologic recovery. This chapter is intended to provide an overview of these risks and serve as a guide for developing such protocols based on the best available evidence.

Keywords

Subarachnoid hemorrhage Early brain injury Hydrocephalus Delayed cerebral ischemia Vasospasm Neurogenic stress cardiomyopathy Neurogenic pulmonary edema Cerebral salt wasting 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Christopher M. Jackson
    • 1
  • Justin M. Caplan
    • 1
  • Judy Huang
    • 1
  • Rafael J. Tamargo
    • 1
    • 2
    Email author
  1. 1.Department of Neurosurgery, Division of Cerebrovascular NeurosurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Neurosciences Critical Care UnitThe Johns Hopkins HospitalBaltimoreUSA

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