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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Triple-H therapy in the management of aneurysmal subarachnoid haemorrhage

Jon Sen1, Antonio Belli, Helen Albon

  • 1Victor Horsley Department of Neurosurgery, of the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. j.sen@ion.ucl.ac.uk

The Lancet. Neurology
|September 25, 2003
PubMed

Cerebral vasospasm is a recognised but poorly understood complication for many patients who have aneurysmal subarachnoid haemorrhage and can lead to delayed ischaemic neurological deficit (stroke). Morbidity and mortality rates for vasospasm are high despite improvements in management. Since the middle of the 1970s, much has been written about the treatment of cerebral vasospasm. Hypervolaemia, hypertension, and haemodilution (triple-H) therapy in an intensive-care setting has been shown in some studies to improve outcome and is an accepted means of treatment, although a randomised controlled trial has never been undertaken. In this review, the rationale for this approach will be discussed, alongside new thoughts and future prospects for the management of this complex disorder.

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