Subarachnoid hemorrhage. Modern view on intensive therapy

Abstract

The objective: to analyze the latest data on the management of patients with subarachnoid hemorrhage (SAH).Results: nimodipine is the only drug that possesses evidence-based efficacy to prevent and treat vasospasm. However, there are cases of refractory vasospasm. Furthermore, there are cases of delayed cerebral ischemia without angiographically detected vasospasm. This article describes the diagnostic, classification of the severity of SAH, the dependence of outcomes on the timing of surgical interventions and intensive care (volemia, glycemia, sodium, hemoglobin level, and optimal values of systolic blood pressure), the results of research on the use of drugs and methods potentially effective for the prevention and treatment of cerebral vasospasm.

Keywords

• subarachnoid hemorrhage
• cerebral vasospasm
• delayed cerebral ischemia
• spreading depolarization