[Intensive care treatment after aneurysmal subarachnoid hemorrhage]

Area of Science:

• Neurology
• Critical Care Medicine
• Neuroinflammation

Background:

• Aneurysmal subarachnoid hemorrhage (SAH) is a life-threatening neurological emergency.
• SAH triggers systemic hyperactivation of the sympathetic nervous system and inflammatory responses, impacting multiple organ systems.
• Neuroendocrinological disorders and cardiopulmonary complications are prevalent in SAH patients.

Purpose of the Study:

• To review the pathophysiology and current management strategies for aneurysmal subarachnoid hemorrhage.
• To highlight the persistent challenges in patient outcomes despite advances in acute care.
• To emphasize the long-term neurological and psychological sequelae experienced by survivors.

Main Methods:

• Literature review focusing on pathophysiology, treatment, and outcomes of aneurysmal subarachnoid hemorrhage.
• Analysis of data regarding mortality, morbidity, and long-term deficits post-SAH.
• Evaluation of the efficacy of interventions, including anti-inflammatory treatments and nimodipine.

Main Results:

• Despite reduced mortality in high-volume centers, a significant proportion of SAH survivors experience lasting neurological deficits.
• Anti-inflammatory treatments have not demonstrated improved outcomes.
• Nimodipine prophylaxis within 96 hours of SAH is the only intervention with proven benefit.
• Over one-third of survivors report depressive episodes or symptoms of post-traumatic stress disorder.

Conclusions:

• Aneurysmal subarachnoid hemorrhage remains a devastating condition with substantial long-term consequences for survivors.
• Current therapeutic strategies offer limited improvement for neurological deficits and psychological sequelae.
• Further research is needed to address the persistent morbidity associated with SAH.