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Published in:

01-09-2017

Emergency Neurological Life Support: Subarachnoid Hemorrhage

Authors: Brian L. Edlow, Owen Samuels

Published in: Neurocritical Care | Special Issue 1/2017

Abstract

Subarachnoid hemorrhage (SAH) is a neurological emergency because it may lead to sudden neurological decline and death and, depending on the cause, has treatment options that can return a patient to normal. Because there are interventions that can be life-saving in the first few hours after onset, SAH was chosen as an Emergency Neurological Life Support (ENLS) protocol.

Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012;43:1711–37.CrossRefPubMed

Diringer MN, Bleck TP, Claude Hemphill J III, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference. Neurocrit Care. 2011;15:211–40.CrossRefPubMed

Edlow JA, Malek AM, Ogilvy CS. Aneurysmal subarachnoid hemorrhage: update for emergency physicians. J Emerg Med. 2008;34:237–51.CrossRefPubMed

Linn FH, Wijdicks EF. Causes and management of thunderclap headache: a comprehensive review. Neurol. 2002;8:279–89.CrossRef

Schievink WI, Karemaker JM, Hageman LM, van der Werf DJ. Circumstances surrounding aneurysmal subarachnoid hemorrhage. Surg Neurol. 1989;32:266–72.CrossRefPubMed

Pope JV, Edlow JA. Favorable response to analgesics does not predict a benign etiology of headache. Headache. 2008;48:944–50.CrossRefPubMed

Edlow JA, Panagos PD, Godwin SA, et al. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. Ann Emerg Med. 2008;52:407–36.CrossRefPubMed

Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. N Engl J Med. 2000;342:29–36.CrossRefPubMed

Vermeulen MJ, Schull MJ. Missed diagnosis of subarachnoid hemorrhage in the emergency department. Stroke. 2007;38:1216–21.CrossRefPubMed

10.

Kowalski RG, Claassen J, Kreiter KT, et al. Initial misdiagnosis and outcome after subarachnoid hemorrhage. JAMA. 2004;291:866–9.CrossRefPubMed

11.

Perry JJ, Stiell IG, Sivilotti ML, et al. High risk clinical characteristics for subarachnoid haemorrhage in patients with acute headache: prospective cohort study. BMJ. 2010;341:c5204.CrossRefPubMedPubMedCentral

12.

Cuvinciuc V, Viguier A, Calviere L, et al. Isolated acute nontraumatic cortical subarachnoid hemorrhage. AJNR Am J Neuroradiol. 2010;31:1355–62.CrossRefPubMed

13.

Byyny RL, Mower WR, Shum N, et al. Sensitivity of noncontrast cranial computed tomography for the emergency department diagnosis of subarachnoid hemorrhage. Ann Emerg Med. 2008;51:697–703.CrossRefPubMed

14.

Cortnum S, Sorensen P, Jorgensen J. Determining the sensitivity of computed tomography scanning in early detection of subarachnoid hemorrhage. Neurosurgery. 2010;66:900–2 discussion 903.PubMed

15.

Perry JJ, Stiell IG, Sivilotti ML, et al. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ. 2011;343:d4277.CrossRefPubMedPubMedCentral

16.

Perry JJ, Sivilotti ML, Stiell IG, et al. Should spectrophotometry be used to identify xanthochromia in the cerebrospinal fluid of alert patients suspected of having subarachnoid hemorrhage? Stroke. 2006;37:2467–72.CrossRefPubMed

17.

Edlow JA, Bruner KS, Horowitz GL. Xanthochromia. Arch Pathol Lab Med. 2002;126:413–5.PubMed

18.

Linn FH, Voorbij HA, Rinkel GJ, et al. Visual inspection versus spectrophotometry in detecting bilirubin in cerebrospinal fluid. J Neurol Neurosurg Psychiatry. 2005;76:1452–4.CrossRefPubMedPubMedCentral

19.

Walton J. Subarachnoid hemorrhage. Edinburgh: E & S Livingstone Ltd.; 1956.

20.

Shah KH, Edlow JA. Distinguishing traumatic lumbar puncture from true subarachnoid hemorrhage. J Emerg Med. 2002;23:67–74.CrossRefPubMed

21.

Perry JJ, Alyahya B, Sivilotti ML, et al. Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: prospective cohort study. BMJ. 2015;350:h568.CrossRefPubMedPubMedCentral

22.

Schull MJ. Lumbar puncture first: an alternative model for the investigation of lone acute sudden headache. Acad Emerg Med. 1999;6:131–6.CrossRefPubMed

23.

Carstairs SD, Tanen DA, Duncan TD, et al. Computed tomographic angiography for the evaluation of aneurysmal subarachnoid hemorrhage. Acad Emerg Med. 2006;13:486–92.CrossRefPubMed

24.

McCormack RF, Hutson A. Can computed tomography angiography of the brain replace lumbar puncture in the evaluation of acute-onset headache after a negative noncontrast cranial computed tomography scan? Acad Emerg Med. 2010;17:444–51.CrossRefPubMed

25.

Edlow JA. What are the unintended consequences of changing the diagnostic paradigm for subarachnoid hemorrhage after brain computed tomography to computed tomographic angiography in place of lumbar puncture? Acad Emerg Med. 2010;17:991–5 discussion 996-7.CrossRefPubMed

26.

Bardach NS, Zhao S, Gress DR, et al. Association between subarachnoid hemorrhage outcomes and number of cases treated at California hospitals. Stroke. 2002;33:1851–6.CrossRefPubMed

27.

Berman MF, Solomon RA, Mayer SA, et al. Impact of hospital-related factors on outcome after treatment of cerebral aneurysms. Stroke. 2003;34:2200–7.CrossRefPubMed

28.

Rabinstein AA, Lanzino G, Wijdicks EF. Multidisciplinary management and emerging therapeutic strategies in aneurysmal subarachnoid haemorrhage. Lancet Neurol. 2010;9:504–19.CrossRefPubMed

29.

Naidech AM, Kreiter KT, Janjua N, et al. Phenytoin exposure is associated with functional and cognitive disability after subarachnoid hemorrhage. Stroke. 2005;36:583–7.CrossRefPubMed

30.

Frontera JA, Lewin JJ 3rd, Rabinstein AA, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: a statement for healthcare professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Neurocritical Care. 2016;24:6–46.CrossRefPubMed

31.

Hillman J, Fridriksson S, Nilsson O, et al. Immediate administration of tranexamic acid and reduced incidence of early rebleeding after aneurysmal subarachnoid hemorrhage: a prospective randomized study. J Neurosurg. 2002;97:771–8.CrossRefPubMed

32.

Dorhout Mees SM, Rinkel GJ, Feigin VL, et al. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2007;1:CD000277.

Title: Emergency Neurological Life Support: Subarachnoid Hemorrhage
Authors: Brian L. Edlow
Owen Samuels
Publication date: 01-09-2017
Publisher: Springer US
Published in: Neurocritical Care / Issue Special Issue 1/2017
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-017-0458-8

At a glance: The STEP trials

Springer Medicine

Emergency Neurological Life Support: Subarachnoid Hemorrhage

Abstract

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Springer Medicine

Abstract

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