Perioperative management of aneurysmal subarachnoid hemorrhage

Nilmani Upadhyaya, MD
Department of Anesthesiology
Medicare National Hospital
Kathmandu
Nepal

Mohan R. Sharma, MS
Division of Neurosurgery
TU Teaching Hospital
Kathmandu, Nepal


Abstract
Subarachnoid hemorrhage (SAH) secondary to ruptured intracranial aneurysms is one of the devastating diseases to treat in neurosurgery with high morbidity and mortality. Successful management of patients with spontaneous SAH involves a collective teamwork of neurosurgeons, neurologists, radiologists, anesthesiologists, intensivists and nurses. Once the patient is scheduled for surgery the role of the anesthesiologists becomes increasingly important and successful outcome from surgery depends on expedious perioperative care of the patient from the anesthesiologists apart from good surgical clipping. In this article, the authors review the management of aneurysmal SAH with emphasis on perioperative care.

Key Words: anesthesia, aneurysm, craniotomy, subarachnoid hemorrhage