Subarachnoid haemorrhage (SAH): medical treatment
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Subarachnoid haemorrhage (SAH): medical treatment. Bed rest in a quiet room, Head of bed elevated to 30 degrees. Fully referenced neurology checklist.
General medical treatment
- Bed rest in a quiet room
- Head of bed elevated to 30 degrees
- Analgesia
- Antiemetics
- Fluid management
- Stool softeners to prevent constipation
- Antacid treatment
- Deep vein thrombosis (DVT) prophylaxis
Blood pressure control
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Seizure management
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Indications for long-term antiepileptic drug (AED) treatment
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Nimodipine
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Other treatments
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Investigational treatments
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References
- Rabinstein AA, Lanzino G, Wijdicks EFM. Multidisciplinary management and emerging therapeutic strategies in aneurysmal subarachnoid haemorrhage. Lancet Neurol 2010; 9:504-519.
- Connolly Jr ES, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012; 43:1711-1737.
- Vivancos J, Gilo F, Frutos R, et al. Clinical management guidelines for subarachnoid haemorrhage: diagnosis and treatment. Neurologia 2014; 29:353-370.
- Hoh BL, Ko NU, Amin-Hanjani S, et al. 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke 2023; 54:e314-e370.
- Vossen LV, Weiss M, Albanna W, et al. Intra-arterial nimodipine for the treatment of refractory delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Neurointerv Surg 2023 (Online ahead of print).
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