Related Experiment Video
Updated: Aug 22, 2026

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage-A German Nationwide
Beate Kranawetter1, Silvia Hernández-Durán2, Tammam Abboud3
1Department of Neurosurgery, University Hospital Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. beate.kranawetter@med.uni-goettingen.de.
Background:
Delayed cerebral ischemia (DCI) remains a major cause of morbidity after aneurysmal subarachnoid hemorrhage (aSAH). Induced hypertension (IH) is frequently used to improve cerebral perfusion in patients with DCI, with current practice primarily supported by observational evidence with inconsistent guideline recommendations. We conducted a nationwide survey to assess current institutional approaches to IH in the management of DCI after aSAH in Germany.
Methods:
An 11-item web-based questionnaire was distributed via LimeSurvey® between May and October 2025 to neurological and neurosurgical departments in Germany involved in the treatment of aSAH. The survey assessed institutional approaches to IH, monitoring and imaging strategies, and DCI treatment.
Results:
Overall, 60/132 departments (45%) responded. IH was used by 56/59 departments (95%), predominantly in patients with suspected DCI (52/59, 88%). MAP-guided therapy was the most commonly applied IH strategy (64%), although hemodynamic targets varied substantially between departments. Noradrenaline was the primary vasopressor used for IH (98%). Transcranial doppler (TCD) ultrasonography was the predominant monitoring modality for DCI detection (93%), whereas advanced neuromonitoring techniques were used less frequently. Computed tomography (CT) perfusion (88%) and CT angiography (79%) were the most commonly applied imaging modalities in suspected DCI. IH alone (47%) or combined with intraarterial spasmolysis (36%) represented the leading first-line therapeutic approaches.
Conclusions:
IH remains a central component of DCI management after aSAH in Germany. Considerable variability regarding hemodynamic targets, monitoring strategies, imaging protocols, and therapeutic strategies highlights the absence of standardized evidence-based treatment approaches.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Increased Intracranial Pressure ll: Pathophysiology
Increased Intracranial Pressure l: Introduction
