Management of raised intracranial pressure in aneurysmal subarachnoid hemorrhage: time for a consensus?

Author:

Alotaibi Naif M.12,Wang Justin Z.3,Pasarikovski Christopher R.3,Guha Daipayan13,Al-Mufti Fawaz4,Mamdani Muhammad5,Saposnik Gustavo67,Schweizer Tom A.136,Macdonald R. Loch136

Affiliation:

1. Institute of Medical Science, Faculty of Medicine, University of Toronto, and

2. Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia;

3. Division of Neurosurgery, Department of Surgery, St Michael’s Hospital, University of Toronto, Ontario, Canada;

4. Department of Neurology and Critical Care, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; and

5. Li Ka Shing Centre for Healthcare Analytics Research and Training, Institute for Clinical Evaluative Sciences;

6. Neuroscience Research Program, Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; and

7. Stroke Outcomes and Decision Neuroscience Research Unit, St. Michael’s Hospital, University of Toronto, Ontario, Canada

Abstract

Elevated intracranial pressure (ICP) is a well-recognized phenomenon in aneurysmal subarachnoid hemorrhage (aSAH) that has been demonstrated to lead to poor outcomes. Despite significant advances in clinical research into aSAH, there are no consensus guidelines devoted specifically to the management of elevated ICP in the setting of aSAH. To treat high ICP in aSAH, most centers extrapolate their treatment algorithms from studies and published guidelines for traumatic brain injury. Herein, the authors review the current management strategies for treating raised ICP within the aSAH population, emphasize key differences from the traumatic brain injury population, and highlight potential directions for future research in this controversial topic.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Neurology (clinical),General Medicine,Surgery

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