ABSTRACT
Aneurysmal subarachnoid hemorrhage (aSAH) continues to be associated with an unacceptably high rate of morbidity and mortality. For those patients who survive the initial insult of the subarachnoid hemorrhage (SAH), further neurologic deterioration or death can still occur due to early rebleeding of the ruptured aneurysm and posthemorrhagic vasospasm. Medical and surgical management is aimed at reducing the incidence of early rebleeding and symptomatic vasospasm. Unfortunately, appropriate management remains challenging. Although animal models and anecdotal experience are helpful in beginning to defi ne appropriate treatment regimens, clinical trials of new management strategies and interventions are essential. Such trials are critical because they offer an opportunity to unequivocally evaluate whether a management scheme based on theories or animal models truly impacts and improves patient outcome. Unfortunately, despite a number of Phase 3 clinical trials, proven effi cacious treatments remain minimal.
