🧠 Aneurysmal Subarachnoid Hemorrhage (aSAH) Management
UseManagement framing of aneurysmal subarachnoid hemorrhage.
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SourceHoh BL, et al. AHA/ASA Guideline for the Management of Aneurysmal Subarachnoid Hemorrhage. Stroke 2…
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
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This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
Early aneurysm securing prevents catastrophic rebleeding; avoid hypotension that harms cerebral perfusion.
When to use
Management framing of aneurysmal subarachnoid hemorrhage.
How it works
Unsecured aneurysm → secure (coil/clip) early, controlling BP with a short-acting agent beforehand. All patients → enteral nimodipine. Acute hydrocephalus → EVD. Symptomatic DCI → induced hypertension + normovolemia (± endovascular therapy).
Key points
- Early aneurysm securing prevents catastrophic rebleeding; avoid hypotension that harms cerebral perfusion.
- Nimodipine is the core preventive measure for delayed cerebral ischemia and improves functional outcome in all aSAH patients.
- Prophylactic hypervolemia, routine statin and IV magnesium are not recommended.
- Maintain normovolemia and electrolytes (hyponatremia common); transfer to a comprehensive stroke center / neuro-ICU.
References
- [Guideline / primary source]Hoh BL, et al. AHA/ASA Guideline for the Management of Aneurysmal Subarachnoid Hemorrhage. Stroke 2023
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Ruptured aneurysm secured (clipping/coiling) | Not secured |
|---|---|
| Acute hydrocephalus / ventricular enlargement with reduced consciousness | Yes |
| Symptomatic vasospasm / delayed cerebral ischemia (DCI) | Yes |
→ActionSecure the aneurysm early + nimodipine
- Secure the aneurysm (urgent)：Treat the ruptured aneurysm as early as possible (coiling or surgical clipping) to prevent rebleeding; before treatment control hypertension with a short-acting agent to prevent rebleeding while avoiding hypotension that harms cerebral perfusion
- Nimodipine (core)：Early enteral nimodipine (timing and duration [Pending update]) to prevent vasospasm and delayed cerebral ischemia (DCI) and improve functional outcome (all aSAH patients)
- Hydrocephalus：Acute hydrocephalus/ventricular enlargement with reduced consciousness: external ventricular drainage (EVD); monitor ICP
| Ruptured aneurysm secured (clipping/coiling) | Secured |
|---|---|
| Acute hydrocephalus / ventricular enlargement with reduced consciousness | No |
| Symptomatic vasospasm / delayed cerebral ischemia (DCI) | No |
→ActionNimodipine + support
- Aneurysm secured：Clipped/coiled: maintain normovolemia and adequate cerebral perfusion; perioperative and follow-up cerebrovascular imaging to monitor for re-rupture/residual
- Nimodipine (core)：Early enteral nimodipine (timing and duration [Pending update]) to prevent vasospasm and delayed cerebral ischemia (DCI) and improve functional outcome (all aSAH patients)
- Avoid：Prophylactic hypervolemia is not recommended (more complications, no benefit); no routine statin or IV magnesium
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Aneurysmal Subarachnoid Hemorrhage (aSAH) Management?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Aneurysmal Subarachnoid Hemorrhage (aSAH) Management upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Aneurysmal Subarachnoid Hemorrhage (aSAH) Management calculated in practice? Can you show a worked example?
- Inputs: Ruptured aneurysm secured (clipping/coiling) Not secured, Acute hydrocephalus / ventricular enlargement with reduced consciousness Yes, Symptomatic vasospasm / delayed cerebral ischemia (DCI) Yes → Result: Action Secure the aneurysm early + nimodipine（Secure the aneurysm (urgent): Treat the ruptured aneurysm as early as possible (coiling or surgical clipping) to prevent rebleeding; before treatment control hypertension with a short-acting agent to prevent rebleeding while avoiding hypotension that harms cerebral perfusion, Nimodipine (core): Early enteral nimodipine (timing and duration [Pending update]) to prevent vasospasm and delayed cerebral ischemia (DCI) and improve functional outcome (all aSAH patients), Hydrocephalus: Acute hydrocephalus/ventricular enlargement with reduced consciousness: external ventricular drainage (EVD); monitor ICP） Inputs: Ruptured aneurysm secured (clipping/coiling) Secured, Acute hydrocephalus / ventricular enlargement with reduced consciousness No, Symptomatic vasospasm / delayed cerebral ischemia (DCI) No → Result: Action Nimodipine + support（Aneurysm secured: Clipped/coiled: maintain normovolemia and adequate cerebral perfusion; perioperative and follow-up cerebrovascular imaging to monitor for re-rupture/residual, Nimodipine (core): Early enteral nimodipine (timing and duration [Pending update]) to prevent vasospasm and delayed cerebral ischemia (DCI) and improve functional outcome (all aSAH patients), Avoid: Prophylactic hypervolemia is not recommended (more complications, no benefit); no routine statin or IV magnesium）