Diagnosis and management of subarachnoid haemorrhage

Suneesh Thilak, Poppy Brown, Tony Whitehouse, Nandan Gautam, Errin Lawrence, Zubair Ahmed and Tonny Veenith ()
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Suneesh Thilak: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital
Poppy Brown: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital
Tony Whitehouse: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital
Nandan Gautam: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital
Errin Lawrence: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital
Zubair Ahmed: University of Birmingham
Tonny Veenith: University of Birmingham

Nature Communications, 2024, vol. 15, issue 1, 1-11

Abstract: Abstract 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.

Date: 2024
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DOI: 10.1038/s41467-024-46015-2

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