Current and evolving management of subarachnoid hemorrhage.

Subarachnoid hemorrhage (SAH) is a catastrophic event that carries a mortality rate of 25% to 50%, with 10% to 15% of patients dying before reaching a hospital. Approximately 30,000 aneurysms rupture each year in the United States. Aneurysmal SAH accounts for 2% to 5% of all new strokes each year. Unlike other types of strokes, the incidence of SAH has not declined over time. As many as 46% of SAH survivors have long-term cognitive impairment, with impact on functional status and quality of life. Modern therapy offers the opportunity to reduce the morbidity of SAH by reducing secondary injury, preventing complications, and reducing the risk of future bleeding events. For most people, an aneurysmal rupture is a life-changing event.