Update on subarachnoid haemorrhage

• Published in: Journal of neurology Vol. 255; no. 4; pp. 465 - 479
• Main Authors: Ferro, J. M., Canhão, P., Peralta, R.
• Format: Journal Article
• Language: English
• Published: Darmstadt Steinkopff-Verlag 01.04.2008; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Brain Ischemia - drug therapy; Brain Ischemia - etiology; Brain Ischemia - physiopathology; Cerebral Arteries - diagnostic imaging; Cerebral Arteries - pathology; Cerebral Arteries - physiopathology; Humans; Hydrocephalus - diagnostic imaging; Hydrocephalus - etiology; Hydrocephalus - therapy; Intracranial Aneurysm - complications; Intracranial Aneurysm - physiopathology; Medical sciences; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosciences; Neurosurgical Procedures - instrumentation; Neurosurgical Procedures - methods; Radiography; Review; Risk Factors; Subarachnoid Hemorrhage - diagnosis; Subarachnoid Hemorrhage - physiopathology; Subarachnoid Hemorrhage - therapy; Vascular diseases and vascular malformations of the nervous system; Vascular Surgical Procedures - instrumentation; Vascular Surgical Procedures - methods; Vasospasm, Intracranial - drug therapy; Vasospasm, Intracranial - etiology; Vasospasm, Intracranial - physiopathology; intracranial aneurysm; subarachnoid haemorrhage; vasospasm; Vascular disease; Vasomotricity; Nervous system diseases; Subarachnoid hemorrhage; Central nervous system disease; Vasoconstriction; Cardiovascular disease; Vasospasm; Cerebrovascular disease; Cerebral disorder
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-008-0606-3

Subarachnoid haemorrhage (SAH) is less frequent than ischaemic stroke or intracerebral haemorrhage, but has a high public health relevance because it can affect young and middle-age adults, has considerable mortality and morbidity, it is treatable and preventable. SAH is traditionally a topic for neurosurgeons. However as endovascular interventions are becoming effective alternatives to surgical treatment, SAH should turn out to be of interest to neurologists, in particular to those devoted to stroke, emergency and neurointensive care.Despite stable incidence, the mortality of SAH has decreased in the last two decades due to better neurosurgical techniques and neurocritical care and to advances in interventional neuroradiological procedures. We review the recent advances in the clinical and diagnostic aspects of SAH and in the genetics of intracranial aneurysms. A systematic review of the treatment of SAH and grading of the available evidence is included.