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Chapter 4 - Prognostication in Subarachnoid Hemorrhage

from Part I - Disease-Specific Prognostication

Published online by Cambridge University Press:  14 November 2024

By
Pirouz Piran ,
Sarah E. Nelson  and
Jose I. Suarez
Edited by
David M. Greer  and
Neha S. Dangayach
David M. Greer
Affiliation:
Boston University School of Medicine and Boston Medical Center
Neha S. Dangayach
Affiliation:
Icahn School of Medicine at Mount Sinai and Mount Sinai Health System
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Summary

Nontraumatic aneurysmal subarachnoid hemorrhage (aSAH) accounts for 5% of all strokes and carries an exceptionally high disease-specific burden: half of patients with aSAH are younger than 55 years, one-third die within the initial days to weeks after ictus, and most survivors have long-term disability or cognitive impairment.[1] For those who survive, there are both short- and long-term consequences that can significantly reduce quality of life. In addition, aSAH can lead to loss of many years of productive life in survivors. Modifiable risk factors for aSAH include hypertension, smoking, and excessive alcohol intake.[2] The global decrease in aSAH incidence has paralleled a decrease in mean blood pressure and smoking prevalence.[3]

Type
Chapter
Information
Neuroprognostication in Critical Care , pp. 75 - 83
Publisher: Cambridge University Press
Print publication year: 2024

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References

Nieuwkamp, DJ, Setz, LE, Algra, A, et al. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol. 2009;8(7):635–42.CrossRefGoogle ScholarPubMed
Feigin, VL, Rinkel, GJ, Lawes, CM, et al. (Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke. 2005;36(12):2773–80.CrossRefGoogle ScholarPubMed
Etminan, N, Chang, HS, Hackenberg, K, et al. Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis. JAMA Neurol. 2019;76(5):588–97.CrossRefGoogle ScholarPubMed
Geraghty, JR and Testai, FD. Delayed cerebral ischemia after subarachnoid hemorrhage: beyond vasospasm and towards a multifactorial pathophysiology. Curr Atheroscler Rep. 2017;19(12):50.CrossRefGoogle ScholarPubMed
Sabri, M, Lass, E, Macdonald, RL. Early brain injury: a common mechanism in subarachnoid hemorrhage and global cerebral ischemia. Stroke Res Treat. 2013;2013:394036.Google ScholarPubMed
Suarez, JI, Tarr, RW, Selman, WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med. 2006;354(4):387–96.CrossRefGoogle ScholarPubMed
Pickard, JD, Murray, GD, Illingworth, R, et al. Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial. BMJ. 1989;298(6674):636–42.CrossRefGoogle ScholarPubMed
Molyneux, A, Kerr, R, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial. J Stroke Cerebrovasc Dis. 2002;11(6):304–14.CrossRefGoogle ScholarPubMed
Zier, LS, Burack, JH, Micc, G, et al. Doubt and belief in physicians’ ability to prognosticate during critical illness: the perspective of surrogate decision makers. Crit Care Med. 2008;36(8):2341.CrossRefGoogle ScholarPubMed
Frontera, JA, Fernandez, A, Schmidt, JM, et al Defining vasospasm after subarachnoid hemorrhage: what is the most clinically relevant definition? Stroke. 2009;40(6):1963–8.CrossRefGoogle ScholarPubMed
Wartenberg, KE, Schmidt, JM, Claassen, , et al. Impact of medical complications on outcome after subarachnoid hemorrhage. Crit Care Med. 2006;34(3):617–23.CrossRefGoogle ScholarPubMed
Le Roux, PD, Elliott, JP, Newell, DW, et al. Predicting outcome in poor-grade patients with subarachnoid hemorrhage: a retrospective review of 159 aggressively managed cases. J Neurosurg. 1996;85(1):39–49.CrossRefGoogle ScholarPubMed
Hunt, WE and Hess, RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28(1):14–20.CrossRefGoogle ScholarPubMed
Hirai, S, Ono, J, Yamaura, A. Clinical grading and outcome after early surgery in aneurysmal subarachnoid hemorrhage. Neurosurgery. 1996;39(3):441–6.Google ScholarPubMed
Giraldo, EA, Mandrekar, JN, Rubin, MN, et al. Timing of clinical grade assessment and poor outcome in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg. 2012;117(1):15–19.CrossRefGoogle ScholarPubMed
Fisher, CM, Kistler, JP, Davis, JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery. 1980;6(1):1–9.CrossRefGoogle ScholarPubMed
Claassen, J, Bernardini, GL, Kreiter, K, et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke. 2001;32(9):2012–20.CrossRefGoogle Scholar
Yoshimoto, Y, Tanaka, Y, Hoya, K. Acute systemic inflammatory response syndrome in subarachnoid hemorrhage. Stroke. 2001;32(9):1989–93.CrossRefGoogle ScholarPubMed
Claassen, J, Carhuapoma, JR, Kreiter, K, et al. Global cerebral edema after subarachnoid hemorrhage: frequency, predictors, and impact on outcome. Stroke. 2002;33(5):1225–32.CrossRefGoogle ScholarPubMed
Claassen, J, Vu, A, Kreiter, KT, et al. Effect of acute physiologic derangements on outcome after subarachnoid hemorrhage. Crit Care Med. 2004;32(3):832–8.CrossRefGoogle ScholarPubMed
Ogilvy, CS and Carter, BS. A proposed comprehensive grading system to predict outcome for surgical management of intracranial aneurysms. Neurosurgery. 1998;42(5):959–68.CrossRefGoogle ScholarPubMed
Maragkos, GA, Enriquez-Marulanda, A. Salem, MM, et al. Proposal of a grading system for predicting discharge mortality and functional outcome in patients with aneurysmal subarachnoid hemorrhage. World Neurosurg. 2019;121: e500–e510.CrossRefGoogle ScholarPubMed
Jaja, BN, Saposnik, G, Lingsma, HF, et al. Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study. BMJ. 2018;362:k4079.Google Scholar
Witsch, J, Frey, HP, Patel, S, et al. Prognostication of long‐term outcomes after subarachnoid hemorrhage: the FRESH score. Ann Neurol. 2016;80(1):46–58.CrossRefGoogle ScholarPubMed
Pace, A, Mitchell, S, Casselden, E, et al. A subarachnoid haemorrhage-specific outcome tool. Brain. 2018;141(4):1111–21.CrossRefGoogle ScholarPubMed
Kondziella, D, Friberg, CK, Wellwood, I, et al. Continuous EEG monitoring in aneurysmal subarachnoid hemorrhage: a systematic review. Neurocrit Care. 2015;22(3):450–61.CrossRefGoogle ScholarPubMed
Nelson, SE, Sair, HI, Stevens, RD. Magnetic resonance imaging in aneurysmal subarachnoid hemorrhage: current evidence and future directions. Neurocrit Care. 2018;29(2):241–52.CrossRefGoogle ScholarPubMed
Chung, DY, Oka, F, Ayata, C. Spreading depolarizations: a therapeutic target against delayed cerebral ischemia after subarachnoid hemorrhage. J Clin Neurophysiol. 2016;33(3):196.CrossRefGoogle ScholarPubMed
Diringer, MN, Bleck, TP, Hemphill, JC. et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference. Neurocrit Care. 2011;15(2):211.CrossRefGoogle ScholarPubMed
Connolly, ES Jr, Rabinstein, AA, Carhuapoma, JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(6):1711–37.CrossRefGoogle ScholarPubMed
Dorhout Mees, SM, Molyneux, AJ, Kerr, RS, Algra, A, Rinkel, GJ. Timing of aneurysm treatment after subarachnoid hemorrhage: relationship with delayed cerebral ischemia and poor outcome. Stroke. 2012;43(8):2126–9.CrossRefGoogle ScholarPubMed
Tateshima, S, Murayama, Y, Gobin, YP, et al. Endovascular treatment of basilar tip aneurysms using Guglielmi detachable coils: anatomic and clinical outcomes in 73 patients from a single institution. Neurosurgery. 2000;47(6):1332–42.CrossRefGoogle ScholarPubMed
Konczalla, J, Seifert, V, Beck, J, et al. Outcome after Hunt and Hess Grade V subarachnoid hemorrhage: a comparison of pre-coiling era (1980–1995) versus post-ISAT era (2005–2014). J Neurosurg. 2017;128(1):100–10.Google ScholarPubMed
Hayashi, M, Handa, Y, Kobayashi, H, et al. Prognosis of intraventricular hemorrhage due to rupture of intracranial aneurysm. Zentralbl Neurochir. 1989;50(3-4):132–7.Google ScholarPubMed
Hasan, D, Vermeulen, M, Wijdicks, EF, Hijdra, A, van Gijn, J. Management problems in acute hydrocephalus after subarachnoid hemorrhage. Stroke. 1989;20(6):747–53.CrossRefGoogle ScholarPubMed
Buczacki, SJ, Kirkpatrick, PJ, Seeley, HM, Hutchinson, PJ. Late epilepsy following open surgery for aneurysmal subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 2004;75(11):1620–2.CrossRefGoogle ScholarPubMed
Claassen, J, Peery, S, Kreiter, KT, et al. Predictors and clinical impact of epilepsy after subarachnoid hemorrhage. Neurology. 2003;60(2):208–14.CrossRefGoogle ScholarPubMed
Roos, YB, de Haan, RJ, Beenen, LFM, et al. Complications and outcome in patients with aneurysmal subarachnoid haemorrhage: a prospective hospital based cohort study in the Netherlands. J Neurol Neurosurg Psychiatry. 2000;68(3):337–41.CrossRefGoogle ScholarPubMed
Etminan, N, Vergouwen, MD, Ilodigwe, D, Macdonald, RL. Effect of pharmaceutical treatment on vasospasm, delayed cerebral ischemia, and clinical outcome in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Cereb Blood Flow Metab. 2011;31(6):1443–51.CrossRefGoogle ScholarPubMed
Ljunggren, B, Brandt, L, Säveland, H, et al. Outcome in 60 consecutive patients treated with early aneurysm operation and intravenous nimodipine. J Neurosurg. 1984;61(5):864–73.CrossRefGoogle ScholarPubMed
Pickard, JD, Murray, GD, Illingworth, R, et al. Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British Aneurysm Nimodipine trial. BMJ. 1989;298(6674):636–42.CrossRefGoogle ScholarPubMed
Hébert, PC, Wells, G, Blajchman, MA, et al. Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Eng J Med. 1999;340(6):409–17.CrossRefGoogle ScholarPubMed
Ayling, OG, Ibrahim, GM, Alotaibi, NM, et al. Anemia after aneurysmal subarachnoid hemorrhage is associated with poor outcome and death. Stroke. 2018;49(8):1859–65.CrossRefGoogle ScholarPubMed
Kramer, AH, Gurka, MJ, Nathan, B, et al. Complications associated with anemia and blood transfusion in patients with aneurysmal subarachnoid hemorrhage. Crit Care Med. 2008;36(7):2070–5.CrossRefGoogle ScholarPubMed
Kramer, AH and Zygun, DA. Anemia and red blood cell transfusion in neurocritical care. Crit Care. 2009;13(3):R89.CrossRefGoogle ScholarPubMed
Hütter, BO and Gilsbach, JM. Which neuropsychological deficits are hidden behind a good outcome (Glasgow = I) after aneurysmal subarachnoid hemorrhage? Neurosurgery. 1993;33(6):999–1006.Google Scholar
Mayer, SA, Kreiter, KT, Copeland, D, et al. Global and domain-specific cognitive impairment and outcome after subarachnoid hemorrhage. Neurology. 2002;59(11):1750–8.CrossRefGoogle ScholarPubMed
Visser-Meily, JA, Rhebergen, ML, Rinkel, GJ, van Zandvoort, MJ, Post, MW. Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage: relationship with psychological symptoms and personality characteristics. Stroke, 2009;40(4):1526–9.CrossRefGoogle ScholarPubMed
Treggiari, MM, Rabinstein, AA, Busl, KM, et al. Guidelines for the neurocritical care management of subarachnoid hemorrhage. Neurocrit Care. 2023;39(1):1–28.CrossRefGoogle ScholarPubMed
Hoh, BL, Ko, NU, Amin-Hanjani, S, et al. 2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2023;55(7):e314–e370.Google Scholar

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