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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
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Time intervals from subarachnoid hemorrhage to rebleed
M R Germans1, B A Coert, W P Vandertop
1Department of Neurosurgery, H2-241, Neurosurgical Center Amsterdam, Academic Medical Center (AMC), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, mrgermans@hotmail.com.
Journal of Neurology
|May 9, 2014
Summary
Rebleeding after aneurysmal subarachnoid hemorrhage (aSAH) is common and often preventable. Many rebleeds occur after hospital admission, suggesting improved in-hospital logistics could reduce this risk and improve patient outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Rebleeding is a major complication after aneurysmal subarachnoid hemorrhage (aSAH), significantly impacting patient prognosis.
- Early intervention is crucial to prevent rebleeds and improve outcomes in aSAH patients.
Purpose of the Study:
- To determine the proportion of aSAH rebleeds that could be prevented by early treatment.
- To analyze the timing and patient location during rebleeding events.
Main Methods:
- Retrospective evaluation of 293 patients treated for aSAH between 2008 and 2011.
- Analysis of patient demographics, clinical grade, outcome scores, and time intervals to hemorrhage, rebleed, and treatment.
- Assessment of patient location at the time of rebleeding.
Main Results:
- Approximately 16% of aSAH patients experienced a rebleed (12% confirmed, 4% possible).
- A majority of rebleeds (60%) occurred after hospital admission, with most happening within 24 hours (median 180 minutes).
- Patients with rebleeds had significantly shorter time to treatment and higher mortality.
Conclusions:
- A substantial proportion of aSAH rebleeds may be preventable through optimized in-hospital logistics and prompt aneurysm securing.
- Improving efficiency in early aneurysm treatment is critical to reduce rebleed rates.
- Further research into interventions like antifibrinolytics is ongoing.
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