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(Stroke. 2009;40:994.)
© 2009 American Heart Association, Inc.

AHA/ASA Guideline

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association

Joshua B. Bederson, MD, Chair; E. Sander Connolly, Jr, MD, FAHA, Vice-Chair; H. Hunt Batjer, MD; Ralph G. Dacey, MD, FAHA; Jacques E. Dion, MD, FRCPC; Michael N. Diringer, MD, FAHA; John E. Duldner, Jr, MD, MS; Robert E. Harbaugh, MD, FAHA; Aman B. Patel, MD Robert H. Rosenwasser, MD, FAHA

Key Words: AHA Scientific Statements • aneurysm • angiography • cerebrovascular disorders • hemorrhage • stroke • surgery • vasospasm

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Subarachnoid hemorrhage (SAH) is a common and frequently devastating condition, accounting for 5% of all strokes and affecting as many as 30 000 Americans each year.^1,2 The American Heart Association (AHA) previously published "Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage."³ Since then, considerable advances have been made in endovascular techniques, diagnostic methods, and surgical and perioperative management paradigms. Nevertheless, outcome for patients with SAH remains poor, with population-based mortality rates as high as 45% and significant morbidity among survivors.^4–9 Several multicenter, prospective, randomized trials and prospective cohort analyses have influenced treatment protocols for SAH. However, rapid evolution of newer treatment modalities, as well as other practical and ethical considerations, has meant that rigorous clinical scientific assessment of the treatment protocols has not been feasible in several important areas.

To address these issues, the Stroke Council of the AHA formed a writing group to reevaluate the recommendations for management of aneurysmal SAH. A consensus committee reviewed existing data in this field and prepared the recommendations in 1994.³ In an effort to update those recommendations, a systematic literature review was conducted based on a search of MEDLINE to identify all relevant randomized clinical trials published between June 30, 1994, and November 1, 2006 (search terms: subarachnoid hemorrhage, cerebral aneurysm, trial; Table 1). Each identified article was reviewed by at least 2 members of the writing group. Selected articles had to meet one of the following criteria to be included: randomized trial or nonrandomized concurrent cohort study. Case . . . [Full Text of this Article]

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