Related Experiment Video
Updated: Jun 23, 2026
10:34
Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Subarachnoid haemorrhage (spontaneous aneurysmal).
Mohsen Javadpour1, Nicholas Silver
1Department of Neurosurgery, Walton Centre for Neurology and Neurosurgery, Liverpool University, Liverpool, UK.
BMJ Clinical Evidence
|May 20, 2009
Summary
This review examines surgical and medical treatments for aneurysmal subarachnoid hemorrhage (SAH). It evaluates interventions like coiling, clipping, and nimodipine for effectiveness and safety.
Area of Science:
- Neurology
- Neurosurgery
- Clinical Evidence
Background:
- Subarachnoid hemorrhage (SAH) is a type of stroke, often caused by ruptured aneurysms.
- Sudden severe headache is a key symptom, but atypical presentations require high clinical suspicion.
- Spontaneous SAH constitutes approximately 5% of all stroke cases.
Purpose of the Study:
- To systematically review the effects of surgical treatments for aneurysmal subarachnoid hemorrhage.
- To assess medical treatments for preventing delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage.
Main Methods:
- Systematic review of literature up to July 2006, including Medline, Embase, and Cochrane Library.
- Inclusion of randomized controlled trials (RCTs) and observational studies.
- Inclusion of safety alerts from regulatory agencies like the FDA and MHRA.
Main Results:
- Six systematic reviews, RCTs, or observational studies met the inclusion criteria.
- GRADE evaluation was performed to assess the quality of evidence for interventions.
- Data on effectiveness and safety of various interventions were compiled.
Conclusions:
- The review presents evidence on endovascular coiling and surgical clipping for aneurysmal SAH.
- Effectiveness and safety of the timing of surgery are discussed.
- Information on oral and intravenous nimodipine for preventing delayed cerebral ischemia is provided.
More Related Videos
Related Concept Videos
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...