Guideline for Management of Aneurysmal Subarachnoid Hemorrhage
Jae Hoon Sung, MD, PhD
Department of Neurosurgery, St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
ABSTRACT
The aneurysmal subarachnoid hemorrhage (SAH) is still challenging neurovascular disease, despite of advanced modern medicine. In 2009, American Heart Association (AHA) published new guidelines for management of SAH. Most outstanding change of this guideline is guarantee of endovascular coiling procedures as curative procedures for SAH. SAH is unique disease entity with the characteristics of high rebleeding rate, unpredictable vasospasm episode, hemodynamic instability and late complications such as hydrocephalus. New guideline stresses the importance of stepwise approach to SAH; symptomatic clues, diagnostic approach, decision making for treatment, merits and demerits between clipping and coiling, and late complications. Collaboration between cerebrovascular and endovascular surgeons is key point for excellent outcome.
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