AHA Guidelines: Aneurysmal Subarachnoid Hemorrhage Guidelines Part I, Introduction and Acute Evaluation

Dr. Brian Hoh, neurosurgeon and chair of neurosurgery at the University of Florida, and Nerissa Ko, neurointensivist and vascular neurologist at UCSF Medical Center in San Francisco, were both instrumental in developing the American Heart Association and American Stroke Association’s new guidelines for treating patients with aneurysmal subarachnoid hemorrhage. These patients have very high mortality rates and are prone to serious complications. But with these guidelines, which pull from all the best available science and research to date, health care providers can create order sets to ensure they give their patients the best possible outcomes. In this episode, Dr. Hoh and Ko explain the severity of aneurysmal subarachnoid hemorrhage, how it typically presents in the acute stage, and they go into detail about diagnostic tools that can detect it. Headache is a very common complaint, but differentiating a common headache from an aneurysmal subarachnoid hemorrhage can mean the difference between life and death.

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AHA Guidelines: Aneurysmal Subarachnoid Hemorrhage Guidelines Part II, Treatment

Once patients have been diagnosed with an aneurysmal subarachnoid hemorrhage, the number one priority is to obliterate the aneurysm as soon as possible and prevent rebleeding. In this episode, Dr. Hoh and Dr. Ko go into more detail about imaging that can definitively diagnose the aneurysm and reveal its precise shape and position in the brain. Once that is established, there are a number of surgery options that the guidelines specify. During a hemorrhage, blood gets into the outside coverings of the brain and is very irritating to tissue—this can result in a number of short-term complications. Dr. Hoh and Ko discuss some of the major ones and reveal how the latest guidelines recommend addressing them, both raising some new ideas and challenging some conventional approaches.

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AHA Guidelines: Aneurysmal Subarachnoid Hemorrhage Guidelines Part III, Complications and Recovery

In the days, weeks, months, and even years after aneurysmal subarachnoid hemorrhage, patients are vulnerable to lots of serious complications. In the episode Dr. Hoh and Dr. Ko are joined by Kiffon Keigher, a nurse practitioner with decades experience in neuroscience, stroke, and neurocritical care. They discuss the essential role that nurses play in caring for patients after their aneurysm is treated, including closely monitoring for complications and treating them quickly when they do arise. Patients can crash quickly, so it is essential to know how to prevent, detect, and treat these serious complications as quickly and effectively as possible. And as patients, their family, and the multidisciplinary care team prepare for discharge, it's important to carefully evaluate their mental and physical state, so they can be set up for success as they return to their life.

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