Prognostic Factors and Targets for Intervention After Subarachnoid Hemorrhage

See related article, pages 2315–2321. Aneurysmal subarachnoid hemorrhage is associated with a high risk of morbidity and mortality. Treatment requires early aneurysm repair to prevent catastrophic rebleeding and intensive medical care to manage associated problems including hydrocephalus, cerebral vasospasm, electrolyte disorders, infection, and seizures. Prognosis after SAH is determined in part by factors that are present from the outset and not modifiable, but recent evidence suggests potential opportunities to improve outcomes.Rosengart et al1 analyzed a large series of patients with ruptured aneurysms and determined that the most important factors leading to unfavorable outcome were cerebral infarction, worse clinical grade on admission, advanced age, fever, and symptomatic vasospasm. Other significant variables were greater clot thickness on admission CT …