December 12, 2014 9:00 — 2 Comments
Formal Protocol Developed for Aneurysmal Subarachnoid Hemorrhage
Neurosurgeons and neurointerventionalists at Kyungpook National University in the Republic of Korea have developed a formal protocol for delivering emergency treatment for patients with subarachnoid hemorrhage (SAH) from ruptured aneurysms within the first few hours after bleeding occurs. The emergency treatment plan is shown to reduce the incidence of repeated hemorrhage during the hospital stay and improve clinical outcomes in patients with aneurysmal SAH. The treatment plan, published in the Journal of Neurosurgery, was tested by comparing the clinical courses of 442 patients treated in this manner between 2008 and 2011, with the clinical courses of 423 patients treated between 2001 and 2004 under a different protocol. Results of the study found that the incidence of in-hospital re-bleeding was significantly lower among patients treated between 2008 and 2011. Additionally, the proportion of favorable outcomes one month after hospital admission was significantly higher among patients treated under the new protocol. To read more about this study, click here.
What about control of the co-morbid conditions like Hypertension, DM, bleeding disorder if were present among patients dealt within 2 hours of hospital admission?
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In a country with centralized care, perhaps the new protocol makes sense. In the United States with a more decentralized system of health care, it is unlikely that a large percentage of freshly ruptured aneurysm patients will find themselves initially in a hospital setting with an immediately available team of interventional radiologists, adequately aneurysm-experienced neurosurgeons, and intensive care specialists to manage associated medical problems. In such settings perhaps one must accept a small rebreeding incidence while appropriate care is organized.
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