Outcome and cost of aneurysmal subarachnoid hemorrhage.

Aneurysmal subarachnoid hemorrhage (aSAH) is a neurosurgical catastrophe. It affects 33,000 patients in the United States annually and has a mortality rate of 50% to 60% at 30 days. Half of the survivors are dependent. Outcome is closely related to the level of consciousness at the time of presentation, global cerebral edema, subarachnoid blood load as seen on CT, and rehemorrhage. Age, hyperglycemia, and medical complications are associated with worse outcomes. The cost impact factor of this condition is high from a financial perspective as well as from a patient perspective. Care givers show increased morbidity when compared with the nonaffected community. Early aggressive treatment of good grade patients seems to provide the best outcome for this serious condition.