Aspects of the Medical Management in Aneurysmal Subarachnoid Hemorrhage

  • J. P. Castel
Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 18)


The severity of an aneurysmal subarachnoid hemorrhage (SAH) is not only related to the direct effect of the initial bleeding, but also to the harmful effects of a number of complications occurring in the first two weeks after the ictus. During this time, careful monitoring of the patient and some medical adjuncts can either prevent the occurrence or limit the effects of these complications. Among them, recurrent hemorrhage from the aneurysm and delayed cerebral ischemia are two major events that can dramatically affect the final outcome. Prevention of rebleeding is assured by the surgical exclusion of the aneurysm, whenever possible. Prevention of delayed cerebral ischemia can only be provided by a medical management either pre- or postoperatively. Various drugs have been tried and most of them abandoned becaused of lack of effect. Recent data suggest a role for that calcium antagonists in the prevention of cerebral ischemic complications. Despite early prevention, however, symptoms of cerebral ischemia can occur and a vigorous treatment is needed to reduce the risks of cerebral infarction. The main goal of this treatment has not changed over the years: improvement of cerebral perfusion pressure and thereby of cerebral blood flow.


Cerebral Ischemia Subarachnoid Hemorrhage Intracranial Aneurysm Cerebral Vasospasm Aneurysmal Subarachnoid Hemorrhage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Wien 1991

Authors and Affiliations

  • J. P. Castel
    • 1
  1. 1.Clinique Universitaire de NeurochirurgieGroupe Hospitalier PellegrinBordeauxFrance

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