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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Management of aneurysmal subarachnoid hemorrhage: a national survey of current practice

Othman Al-Helli1, Steven Bush1, Harshal Ingale1

  • 1Departments of Neurosurgery and Radiology, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Journal of Neurointerventional Surgery
|October 22, 2014
PubMed

Insights

Most UK and Ireland neurosurgical units followed key recommendations for aneurysmal subarachnoid hemorrhage (aSAH) management six months post-NCEPOD report. However, variability in clinical practice was observed, particularly in weekend interventional neuroradiological treatment.

Area of Science:

  • Neurosurgery
  • Neurology
  • Public Health

Background:

  • Clinical guidelines for aneurysmal subarachnoid hemorrhage (aSAH) were published in 2012 and 2013 by major professional bodies.
  • The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report highlighted critical areas for aSAH management.
  • Assessing adherence to these recommendations is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the adoption of 2012/2013 aSAH management recommendations in UK and Ireland neurosurgical units.
  • To compare current practices with 2011 NCEPOD data.
  • To identify areas of consistent adherence and variability in aSAH care.

Main Methods:

  • A 19-question survey was developed to assess aSAH management protocols.
  • Telephone interviews were conducted with on-call neurosurgical registrars across participating centers.
  • Data collection occurred 6 months after the NCEPOD report publication.

Main Results:

  • 22 out of 30 centers aimed for 48-hour treatment of ruptured aneurysms (coiling or clipping).
  • Only 15 units provided regular weekend interventional neuroradiological treatment.
  • Multidisciplinary team discussions for all aSAH patients occurred routinely in 9 units.

Conclusions:

  • The majority of neurosurgical units met most key recommendations for aSAH management 6 months post-NCEPOD report.
  • Significant variability in clinical practice was noted across different units.
  • Further efforts are needed to ensure consistent implementation of best practices, especially for weekend care and multidisciplinary collaboration.
Abstract

Keywords:
AneurysmSubarachnoid

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