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Spontaneous subarachnoid haemorrhage

The Lancet (British edition), 2017-02, Vol.389 (10069), p.655-666 [Peer Reviewed Journal]

Elsevier Ltd ;2017 Elsevier Ltd ;Copyright © 2017 Elsevier Ltd. All rights reserved. ;Copyright Elsevier Limited Feb 11, 2017 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(16)30668-7 ;PMID: 27637674 ;CODEN: LANCAO

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  • Title:
    Spontaneous subarachnoid haemorrhage
  • Author: Macdonald, R Loch, Prof ; Schweizer, Tom A, PhD
  • Subjects: Aneurysms ; Genetic Predisposition to Disease ; Hemorrhage ; Humans ; Internal Medicine ; Neurological disorders ; Prognosis ; Risk Factors ; Subarachnoid Hemorrhage - diagnosis ; Subarachnoid Hemorrhage - epidemiology ; Subarachnoid Hemorrhage - genetics ; Subarachnoid Hemorrhage - therapy ; Traumatic brain injury
  • Is Part Of: The Lancet (British edition), 2017-02, Vol.389 (10069), p.655-666
  • Description: Summary Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life. Additionally, those deficits are frequently accompanied by mood disorders, fatigue, and sleep disturbances. Management requires specialised neurological intensive care units and multidisciplinary clinical expertise, which is better provided in high-volume centres. Many clinical trials have been done, but only two interventions are shown to improve outcome. Challenges that remain relate to prevention of subarachnoid haemorrhage by improved screening and development of lower-risk methods to repair or stabilise aneurysms that have not yet ruptured. Multicentre cooperative efforts might increase the knowledge that can be gained from clinical trials, which is often limited by small studies with differing criteria and endpoints that are done in single centres. Outcome assessments that incorporate finer assessment of neurocognitive function and validated surrogate imaging or biomarkers for outcome could also help to advance the specialty.
  • Publisher: England: Elsevier Ltd
  • Language: English
  • Identifier: ISSN: 0140-6736
    EISSN: 1474-547X
    DOI: 10.1016/S0140-6736(16)30668-7
    PMID: 27637674
    CODEN: LANCAO
  • Source: ProQuest One Psychology
    MEDLINE
    ProQuest Central
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