Subarachnoid Hemorrhage: Clinical relevance and therapeutic management with focus on novel endovascular procedures

Abstract

Subarachnoid hemorrhage is a specific form in the group of intracranial hemorrhages. Although it doesn’t
implicate directly functional neuronal structures since the extravasation of blood is extra-axial, it may cause
severe neurologic dysfunctionalities or even death. This is mostly due to the increase of intracranial pressure, the hyper-stimulation of sympathetic system in the acute phase and severe complications of SAH like
vasospasm and hydrocephalous. Clinical severity and prognosis of SAH is related, although not always,
with the amount of extravasated blood. In vast majority, non-traumatic SAH is related to rupture of intracranial aneurysms. Treatment of SAH is multimodal and implies the stabilization of the ruptured aneurysm
and treatment of its severe complications. This requires drug regimes, surgical operations and neurointerventional methods and should be undertaken from a multidisciplinary team. Interventional neuroradiologists have an important role recently, since endovascular techniques are nowadays first-line treatments in
the treatment of the primary cause but also for its complications like vasospasm.