Future Research on Subarachnoid Hemorrhage: Guilherme Dabus, MD

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Aneurysmal subarachnoid hemorrhage (SAH), a severely morbid and often deadly condition, is a significant global public health threat. Prehospital mortality rates from SAH have been reported to be between 22% and 26%, with these figures potentially rising in the coming years as the population continues to age. These persistently high in-hospital and prehospital mortality rates and increased incidence in the aging population call for improved therapies and practice standards in the management of patients with SAH.

Earlier this year, several notable experts in the field published new guidelines recommendations for the management of SAH, replacing the previous guidelines from 2012. Among the take-home messages noted, the first included improving timely and equitable access to health care system resources such as comprehensive stroke centers to improve overall patient outcomes. Additionally, the guidelines stressed that centers that comprise of dedicated neurocritical care units, experience with higher case volumes, and physician expertise in aneurysm treatment lead to lower mortality and increased likelihood of good functional outcomes.

The guidelines also direct clinicians to useful approaches to detect cerebral vasospasm and predict delayed cerebral ischemic, 2 significant complications of SAH. These include diagnostic modalities, including transcranial Doppler, computed tomography angiography, and computed tomography perfusion, as well as continuous electroencephalography and invasive monitoring.

NeurologyLive^® recently sat down with Guilherme Dabus, MD, codirector of interventionalneuroradiology and vice-chief of the department of neuroscience at Baptist Health Miami Neuroscience Institute, to discuss the state of SAH research and the questions that still remain. Dabus described some of the complexities with understanding and treating vasospasms, needed research on the pathophysiology of delayed cerebral ischemia, and where efforts should be dedicated to improve the overall management of SAH.