Division of Neurocritical Care, Department of Neurology, Boston Medical Center, Boston, MA, USA; Division of Neurocritical Care, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Neurovascular Research Unit, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Department of Neurology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA; Department of Neurosurgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA; Department of Radiology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
Neurol Clin. 2021 May;39(2):419-442. doi: 10.1016/j.ncl.2021.02.006. Epub 2021 Mar 31.
Aneurysmal subarachnoid hemorrhage is a neurologic emergency that requires immediate patient stabilization and prompt diagnosis and treatment. Early measures should focus on principles of advanced cardiovascular life support. The aneurysm should be evaluated and treated in a comprehensive stroke center by a multidisciplinary team capable of endovascular and, operative approaches. Once the aneurysm is secured, the patient is best managed by a dedicated neurocritical care service to prevent and manage complications, including a syndrome of delayed neurologic decline. The goal of such specialized care is to prevent secondary injury, reduce length of stay, and improve outcomes for survivors of the disease.
颅内动脉瘤性蛛网膜下腔出血是一种神经急症,需要立即对患者进行稳定,并迅速做出诊断和治疗。早期措施应侧重于高级心血管生命支持的原则。应通过能够进行血管内和手术治疗的多学科团队在综合卒中中心对动脉瘤进行评估和治疗。一旦动脉瘤得到固定,最好由专门的神经危重病护理服务来管理患者,以预防和处理并发症,包括迟发性神经功能下降综合征。这种专门护理的目的是预防继发性损伤,缩短住院时间,并改善疾病幸存者的预后。