Should be an MDT decision made by experienced surgeons and radiologists Decision based on: Characteristics of the patient: Surgical approach favoured in younger age and in presence of space occupying ICH Radiological approach favoured in older age, poor grade SAH and...
Securing of the aneurysm should be performed as early as is feasible in the majority of patients to reduce rebleeding The aim should be to intervene within 72 hours of first symptoms ESO Guidelines...
Coiling Clipping Stenting Trapping Endovascular treatment which involves navigating a catheter to the aneurysm site under fluoroscopic guidanceA microcatheter is then advanced into the aneurysm sac and metal coils are depositedCoils arrest blood flow and induces...
The calcium-channel blocker nimodipine, the only drug known to improve outcomes following subarachnoid haemorrhage: Reduces risk of death or severe dependency (RR 0.81, NNT 19) Acts as a calcium channel antagonist: Blocks the slow calcium channel of vascular smooth...
Unsecured Aneurysm(Before clipping /coiling) Secured Aneurysm(After clipping /coiling) Systolic pressure should be maintained <180-160 mmHg (ESO / AHA guidance) to reduce risk of rebleedingMay be achieved with nimodipine and analgesiaIf required a titratable agent...
