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Challenging Topics in Neuroanesthesia and Neurocritical Care pp 97–106Cite as

Aneurysmal Subarachnoid Hemorrhage

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Abstract

Subarachnoid hemorrhage (SAH) is a form of stroke with increasing incidence and significance to practitioners in neuroanesthesia and neurocritical care. Despite the evolution of interventional and surgical treatment technologies, SAH initiates a chain of secondary pathophysiological processes that can materially affect outcome despite successful control of the point of bleeding. Treatment principles must focus on these multisystem processes as well as on the maintenance of cerebrovascular integrity, and the effect of dedicated comprehensive neurocritical care can consequently benefit outcome. Bundled “Triple-H” protocols have been refined to emphasize euvolemia and perfusion, while pharmaceutical treatments of SAH-associated vasospasm have not been shown to be effective. These new perspectives force clinicians to refresh pathophysiological paradigms, and consider new therapeutic strategies.

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References

  1. Connolly ES, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(6):1711–37.

    Article  PubMed  Google Scholar 

  2. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8(4):355–69.

    Article  PubMed  Google Scholar 

  3. Ingall T, Asplund K, Mahonen M, Bonita R. A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke. 2000;31(5):1054–61.

    Article  CAS  PubMed  Google Scholar 

  4. Pobereskin LH. Incidence and outcome of subarachnoid haemorrhage: a retrospective population based study. J Neurol Neurosurg Psychiatry. 2001;70(3):340–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Johnston SC, Selvin S, Gress DR. The burden, trends, and demographics of mortality from subarachnoid hemorrhage. Neurology. 1998;50(5):1413–8.

    Article  CAS  PubMed  Google Scholar 

  6. Schievink WI. Intracranial aneurysms. N Engl J Med. 1997;336(1):28–40.

    Article  CAS  PubMed  Google Scholar 

  7. Sforza DM, Putman CM, Cebral JR. Hemodynamics of cerebral aneurysms. Annu Rev Fluid Mech. 2009;41:91–107.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Stapf C, Mohr JP, Pile-Spellman J, Sciacca RR, Hartmann A, Schumacher HC, et al. Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation. J Neurol Neurosurg Psychiatry. 2002;73(3):294–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. van Gijn J, Rinkel GJ. Subarachnoid haemorrhage: diagnosis, causes and management. Brain. 2001;124(Pt 2):249–78.

    Article  PubMed  Google Scholar 

  10. Linn FH, Wijdicks EF, van der Graaf Y, Weerdesteyn-van Vliet FA, Bartelds AI, van Gijn J. Prospective study of sentinel headache in aneurysmal subarachnoid haemorrhage. Lancet. 1994;344(8922):590–3.

    Article  CAS  PubMed  Google Scholar 

  11. Morgenstern LB, Luna-Gonzales H, Huber Jr JC, Wong SS, Uthman MO, Gurian JH, et al. Worst headache and subarachnoid hemorrhage: prospective, modern computed tomography and spinal fluid analysis. Ann Emerg Med. 1998;32(3 Pt 1):297–304.

    CAS  PubMed  Google Scholar 

  12. Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. N Engl J Med. 2000;342(1):29–36.

    Article  CAS  PubMed  Google Scholar 

  13. Perry JJ, Sivilotti ML, Stiell IG, Wells GA, Raymond J, Mortensen M, et al. Should spectrophotometry be used to identify xanthochromia in the cerebrospinal fluid of alert patients suspected of having subarachnoid hemorrhage? Stroke. 2006;37(10):2467–72.

    Article  PubMed  Google Scholar 

  14. UK-I JM, Koo B, Trivedi RA, Higgins NJ, Tay KY, Cross JJ, et al. Current diagnostic approaches to subarachnoid haemorrhage. Eur Radiol. 2005;15(6):1135–47.

    Article  Google Scholar 

  15. Kumar A, Kato Y, Hayakawa M, Junpei O, Watabe T, Imizu S, et al. Recent advances in diagnostic approaches for sub-arachnoid hemorrhage. Asian J Neurosurg. 2011;6(2):94–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28(1):14–20.

    Article  CAS  PubMed  Google Scholar 

  17. Report of World Federation of Neurological Surgeons Committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg. 1988;68(6):985–6.

    Google Scholar 

  18. Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery. 1980;6(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  19. van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. Validation of a prognostic subarachnoid hemorrhage grading scale derived directly from the Glasgow Coma Scale. Stroke. 2008;39(4):1347–8.

    Article  PubMed  Google Scholar 

  20. Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, et al. Subarachnoid hemorrhage: who dies, and why? Crit Care. 2015;19:309.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Starke RM, Connolly Jr ES. Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid H. Rebleeding after aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2011;15(2):241–6.

    Article  CAS  PubMed  Google Scholar 

  22. Larsen CC, Astrup J. Rebleeding after aneurysmal subarachnoid hemorrhage: a literature review. World Neurosurg. 2013;79(2):307–12.

    Article  PubMed  Google Scholar 

  23. Fridriksson S, Saveland H, Jakobsson KE, Edner G, Zygmunt S, Brandt L, et al. Intraoperative complications in aneurysm surgery: a prospective national study. J Neurosurg. 2002;96(3):515–22.

    Article  PubMed  Google Scholar 

  24. Pinna G, Pasqualin A, Vivenza C, Da Pian R. Rebleeding, ischaemia and hydrocephalus following anti-fibrinolytic treatment for ruptured cerebral aneurysms: a retrospective clinical study. Acta Neurochir. 1988;93(3–4):77–87.

    Article  CAS  PubMed  Google Scholar 

  25. Harrigan MR, Rajneesh KF, Ardelt AA, Fisher WS 3rd. Short-term antifibrinolytic therapy before early aneurysm treatment in subarachnoid hemorrhage: effects on rehemorrhage, cerebral ischemia, and hydrocephalus. Neurosurgery. 2010;67(4):935–9; discussion 9–40.

    Google Scholar 

  26. Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med. 2006;354(4):387–96.

    Article  CAS  PubMed  Google Scholar 

  27. Wijdicks EF, Vermeulen M, Murray GD, Hijdra A, van Gijn J. The effects of treating hypertension following aneurysmal subarachnoid hemorrhage. Clin Neurol Neurosurg. 1990;92(2):111–7.

    Article  CAS  PubMed  Google Scholar 

  28. Molyneux AJ, Birks J, Clarke A, Sneade M, Kerr RS. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT). Lancet. 2015;385(9969):691–7.

    Article  PubMed  PubMed Central  Google Scholar 

  29. van Gijn J, Hijdra A, Wijdicks EF, Vermeulen M, van Crevel H. Acute hydrocephalus after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1985;63(3):355–62.

    Article  PubMed  Google Scholar 

  30. Dorai Z, Hynan LS, Kopitnik TA, Samson D. Factors related to hydrocephalus after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2003;52(4):763–9; discussion 9–71.

    Google Scholar 

  31. Ochiai H, Yamakawa Y. Continuous lumbar drainage for the preoperative management of patients with aneurysmal subarachnoid hemorrhage. Neurol Med Chir (Tokyo). 2001;41(12):576–80; discussion 81.

    Google Scholar 

  32. Dorsch N. A clinical review of cerebral vasospasm and delayed ischaemia following aneurysm rupture. Acta Neurochir Suppl. 2011;110(Pt 1):5–6.

    PubMed  Google Scholar 

  33. Dorsch NW, King MT. A review of cerebral vasospasm in aneurysmal subarachnoid haemorrhage Part I: incidence and effects. J Clin Neurosci. 1994;1(1):19–26.

    Article  CAS  PubMed  Google Scholar 

  34. Macdonald RL, Higashida RT, Keller E, Mayer SA, Molyneux A, Raabe A, et al. Clazosentan, an endothelin receptor antagonist, in patients with aneurysmal subarachnoid haemorrhage undergoing surgical clipping: a randomised, double-blind, placebo-controlled phase 3 trial (CONSCIOUS-2). Lancet Neurol. 2011;10(7):618–25.

    Article  CAS  PubMed  Google Scholar 

  35. Etminan N, Vergouwen MD, Ilodigwe D, Macdonald RL. Effect of pharmaceutical treatment on vasospasm, delayed cerebral ischemia, and clinical outcome in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Cereb Blood Flow Metab. 2011;31(6):1443–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Etminan N, Vergouwen MD, Macdonald RL. Angiographic vasospasm versus cerebral infarction as outcome measures after aneurysmal subarachnoid hemorrhage. Acta Neurochir Suppl. 2013;115:33–40.

    PubMed  Google Scholar 

  37. Claassen J, Bernardini GL, Kreiter K, Bates J, Du YE, Copeland D, et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke. 2001;32(9):2012–20.

    Article  CAS  PubMed  Google Scholar 

  38. Lee KH, Lukovits T, Friedman JA. “Triple-H” therapy for cerebral vasospasm following subarachnoid hemorrhage. Neurocrit Care. 2006;4(1):68–76.

    Article  PubMed  Google Scholar 

  39. Diringer MN, Bleck TP, Claude Hemphill 3rd J, Menon D, Shutter L, Vespa P, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference. Neurocrit Care. 2011;15(2):211–40.

    Article  PubMed  Google Scholar 

  40. Bederson JB, Connolly Jr ES, Batjer HH, Dacey RG, Dion JE, Diringer MN, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40(3):994–1025.

    Article  PubMed  Google Scholar 

  41. Treggiari MM, Walder B, Suter PM, Romand JA. Systematic review of the prevention of delayed ischemic neurological deficits with hypertension, hypervolemia, and hemodilution therapy following subarachnoid hemorrhage. J Neurosurg. 2003;98(5):978–84.

    Article  PubMed  Google Scholar 

  42. Feigin VL, Rinkel GJ, Algra A, van Gijn J. Circulatory volume expansion for aneurysmal subarachnoid hemorrhage. Cochrane Database Syst Rev. 2000;2:CD000483.

    Google Scholar 

  43. Sillberg VA, Wells GA, Perry JJ. Do statins improve outcomes and reduce the incidence of vasospasm after aneurysmal subarachnoid hemorrhage: a meta-analysis. Stroke. 2008;39(9):2622–6.

    Article  CAS  PubMed  Google Scholar 

  44. Rinkel GJ, Feigin VL, Algra A, van den Bergh WM, Vermeulen M, van Gijn J. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2005;(1):CD000277.

    Google Scholar 

  45. Dorhout Mees SM, Rinkel GJ, Feigin VL, Algra A, van den Bergh WM, Vermeulen M, et al. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2007;(3):CD000277.

    Google Scholar 

  46. Roos YBWEM, Levi M, Carroll TA, Beenen LFM, Vermeulen M. Nimodipine increases fibrinolytic activity in patients with aneurysmal subarachnoid hemorrhage. Stroke. 2001;32(8):1860–2.

    Article  CAS  PubMed  Google Scholar 

  47. Jun P, Ko NU, English JD, Dowd CF, Halbach VV, Higashida RT, et al. Endovascular treatment of medically refractory cerebral vasospasm following aneurysmal subarachnoid hemorrhage. AJNR Am J Neuroradiol. 2010;31(10):1911–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Shankar JJ, dos Santos MP, Deus-Silva L, Lum C. Angiographic evaluation of the effect of intra-arterial milrinone therapy in patients with vasospasm from aneurysmal subarachnoid hemorrhage. Neuroradiology. 2011;53(2):123–8.

    Article  PubMed  Google Scholar 

  49. Smith WS, Dowd CF, Johnston SC, Ko NU, DeArmond SJ, Dillon WP, et al. Neurotoxicity of intra-arterial papaverine preserved with chlorobutanol used for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Stroke. 2004;35(11):2518–22.

    Article  CAS  PubMed  Google Scholar 

  50. Terry A, Zipfel G, Milner E, Cross 3rd DT, Moran CJ, Diringer MN, et al. Safety and technical efficacy of over-the-wire balloons for the treatment of subarachnoid hemorrhage-induced cerebral vasospasm. Neurosurg Focus. 2006;21(3):E14.

    Article  PubMed  Google Scholar 

  51. Wartenberg KE, Schmidt JM, Claassen J, Temes RE, Frontera JA, Ostapkovich N, et al. Impact of medical complications on outcome after subarachnoid hemorrhage. Crit Care Med. 2006;34(3):617–23; quiz 24.

    Google Scholar 

  52. Manninen PH, Ayra B, Gelb AW, Pelz D. Association between electrocardiographic abnormalities and intracranial blood in patients following acute subarachnoid hemorrhage. J Neurosurg Anesthesiol. 1995;7(1):12–6.

    Article  CAS  PubMed  Google Scholar 

  53. Szabo MD, Crosby G, Hurford WE, Strauss HW. Myocardial perfusion following acute subarachnoid hemorrhage in patients with an abnormal electrocardiogram. Anesth Analg. 1993;76(2):253–8.

    Article  CAS  PubMed  Google Scholar 

  54. Hravnak M, Frangiskakis JM, Crago EA, Chang Y, Tanabe M, Gorcsan 3rd J, et al. Elevated cardiac troponin I and relationship to persistence of electrocardiographic and echocardiographic abnormalities after aneurysmal subarachnoid hemorrhage. Stroke. 2009;40(11):3478–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Mayer SA, LiMandri G, Sherman D, Lennihan L, Fink ME, Solomon RA, et al. Electrocardiographic markers of abnormal left ventricular wall motion in acute subarachnoid hemorrhage. J Neurosurg. 1995;83(5):889–96.

    Article  CAS  PubMed  Google Scholar 

  56. Deininger MH, Radicke D, Buttler J, Scheufler KM, Freiman T, Zentner JF. Tako-tsubo cardiomyopathy: reversible heart failure with favorable outcome in patients with intracerebral hemorrhage. Case Rep J Neurosurg. 2006;105(3):465–7.

    Google Scholar 

  57. Jain R, Deveikis J, Thompson BG. Management of patients with stunned myocardium associated with subarachnoid hemorrhage. AJNR Am J Neuroradiol. 2004;25(1):126–9.

    PubMed  Google Scholar 

  58. Gruber A, Reinprecht A, Gorzer H, Fridrich P, Czech T, Illievich UM, et al. Pulmonary function and radiographic abnormalities related to neurological outcome after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1998;88(1):28–37.

    Article  CAS  PubMed  Google Scholar 

  59. Gruber A, Reinprecht A, Illievich UM, Fitzgerald R, Dietrich W, Czech T, et al. Extracerebral organ dysfunction and neurologic outcome after aneurysmal subarachnoid hemorrhage. Crit Care Med. 1999;27(3):505–14.

    Article  CAS  PubMed  Google Scholar 

  60. Kasuya H, Onda H, Yoneyama T, Sasaki T, Hori T. Bedside monitoring of circulating blood volume after subarachnoid hemorrhage. Stroke. 2003;34(4):956–60.

    Article  PubMed  Google Scholar 

  61. Kahn JM, Caldwell EC, Deem S, Newell DW, Heckbert SR, Rubenfeld GD. Acute lung injury in patients with subarachnoid hemorrhage: incidence, risk factors, and outcome. Crit Care Med. 2006;34(1):196–202.

    Article  PubMed  Google Scholar 

  62. Rosenberg NF, Koht A, Naidech AM. Anemia and transfusion after aneurysmal subarachnoid hemorrhage. J Neurosurg Anesthesiol. 2013;25(1):66–74.

    Article  PubMed  Google Scholar 

  63. Kramer AH, Diringer MN, Suarez JI, Naidech AM, Macdonald LR, Le Roux PD. Red blood cell transfusion in patients with subarachnoid hemorrhage: a multidisciplinary North American survey. Crit Care. 2011;15(1):R30.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Oliveira-Filho J, Ezzeddine MA, Segal AZ, Buonanno FS, Chang Y, Ogilvy CS, et al. Fever in subarachnoid hemorrhage: relationship to vasospasm and outcome. Neurology. 2001;56(10):1299–304.

    Article  CAS  PubMed  Google Scholar 

  65. Douds GL, Tadzong B, Agarwal AD, Krishnamurthy S, Lehman EB, Cockroft KM. Influence of fever and hospital-acquired infection on the incidence of delayed neurological deficit and poor outcome after aneurysmal subarachnoid hemorrhage. Neurol Res Int. 2012;2012:6.

    Article  Google Scholar 

  66. Badjatia N, Fernandez L, Schmidt JM, Lee K, Claassen J, Connolly ES, et al. Impact of induced normothermia on outcome after subarachnoid hemorrhage: a case-control study. Neurosurgery. 2010;66(4):696–700; discussion −1.

    Google Scholar 

  67. Harrigan MR. Cerebral salt wasting syndrome: a review. Neurosurgery. 1996;38(1):152–60.

    Article  CAS  PubMed  Google Scholar 

  68. Qureshi AI, Suri MF, Sung GY, Straw RN, Yahia AM, Saad M, et al. Prognostic significance of hypernatremia and hyponatremia among patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2002;50(4):749–55; discussion 55–6.

    Google Scholar 

  69. Berendes E, Walter M, Cullen P, Prien T, Van Aken H, Horsthemke J, et al. Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage. Lancet. 1997;349(9047):245–9.

    Article  CAS  PubMed  Google Scholar 

  70. Sherlock M, O'Sullivan E, Agha A, Behan LA, Rawluk D, Brennan P, et al. The incidence and pathophysiology of hyponatraemia after subarachnoid haemorrhage. Clin Endocrinol (Oxf). 2006;64(3):250–4.

    Article  Google Scholar 

  71. Cowley Jr AW, Roman RJ. Control of blood and extracellular volume. Baillieres Clin Endocrinol Metab. 1989;3(2):331–69.

    Article  PubMed  Google Scholar 

  72. Nagano A, Yamada Y, Miyake H, Domen K, Koyama T. Increased resting energy expenditure after endovascular coiling for subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2016;25(4):813–8.

    Article  PubMed  Google Scholar 

  73. Badjatia N, Monahan A, Carpenter A, Zimmerman J, Schmidt JM, Claassen J, et al. Inflammation, negative nitrogen balance, and outcome after aneurysmal subarachnoid hemorrhage. Neurology. 2015;84(7):680–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Kasuya H, Kawashima A, Namiki K, Shimizu T, Takakura K. Metabolic profiles of patients with subarachnoid hemorrhage treated by early surgery. Neurosurgery. 1998;42(6):1268–74; discussion 74–5.

    Google Scholar 

  75. Suarez JI, Zaidat OO, Suri MF, Feen ES, Lynch G, Hickman J, et al. Length of stay and mortality in neurocritically ill patients: impact of a specialized neurocritical care team. Crit Care Med. 2004;32(11):2311–7.

    Article  PubMed  Google Scholar 

  76. Varelas PN, Conti MM, Spanaki MV, Potts E, Bradford D, Sunstrom C, et al. The impact of a neurointensivist-led team on a semiclosed neurosciences intensive care unit. Crit Care Med. 2004;32(11):2191–8.

    Article  PubMed  Google Scholar 

  77. Samuels O, Webb A, Culler S, Martin K, Barrow D. Impact of a dedicated neurocritical care team in treating patients with aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2011;14(3):334–40.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Divisions of Perioperative Neurosciences and Critical Care Medicine, Department of Anesthesiology & Pain Medicine, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, USA

    Pratik V. Patel MD & Michael J. Souter MB ChB, FRCA, FNCS

  2. Department of Neurological Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, USA

    Michael J. Souter MB ChB, FRCA, FNCS

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Correspondence to Michael J. Souter MB ChB, FRCA, FNCS .

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  1. Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran, Iran

    Zahid Hussain Khan

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Patel, P.V., Souter, M.J. (2017). Aneurysmal Subarachnoid Hemorrhage. In: Khan, Z. (eds) Challenging Topics in Neuroanesthesia and Neurocritical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-41445-4_7

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