Aneurysmal Subarachnoid Hemorrhage.

Aneurysmal Subarachnoid Hemorrhage.
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DOI:
10.1016/j.ncl.2021.02.006
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发表时间:
2021-05
期刊:
影响因子:
2.4
通讯作者:
Nguyen TN
Nguyen TN
中科院分区:
医学4区
文献类型:
--
作者:
Chung DY;Abdalkader M;Nguyen TN

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动脉瘤性蛛网膜下腔出血是一种神经系统急症,需要迅速稳定患者,诊断和治疗。虽然严重头痛的经典表现很常见,但有广泛的表现,包括轻度疼痛和昏迷。根据两项随机临床试验,在大多数情况下,治疗进展已转向破裂动脉瘤的早期血管内弹簧圈栓塞术。在动脉瘤固定后,有证据表明,患者最好在接受过神经重症监护专业培训的多学科团队的中心接受服务。SAH患者的重症监护管理对于治疗和减轻并发症,特别是迟发性神经功能衰退综合征至关重要。进一步的研究对于优化急性护理和改善蛛网膜下腔出血患者的结局至关重要。
Aneurysmal subarachnoid hemorrhage is a neurological emergency that requires prompt patient stabilization, diagnosis, and treatment. While the classic presentation of a severe headache is common, there are a wide range of presentations including mild pain and coma. Treatment advances have moved towards early endovascular coiling of the ruptured aneurysm in most cases, based on two randomized clinical trials. Following securing of the aneurysm, there is evidence that patients are best served at centers employing multidisciplinary teams with specialized training in neurocritical care. The critical care management of the SAH patient is essential for treatment and mitigation of complications, in particular a syndrome of delayed neurological decline. Further study is essential for optimizing the acute care and improving outcomes in patients with aneurysmal SAH.
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