"Subarachnoid Hemorrhage: Review of Latest Management Approaches".

Authors

Camila Narvaez-Caicedo, Thomas P Bleck

Published in

Current neurology and neuroscience reports. Volume 26. Issue 1. Oct 27, 2026. Epub Oct 27, 2026.

Abstract

This review summarizes recent advances in the management of aneurysmal subarachnoid hemorrhage (aSAH) since the 2023 Neurocritical Care Society and American Heart Association/American Stroke Association guidelines, with a focus on strategies targeting secondary brain injury and delayed cerebral ischemia (DCI).
Recent studies evaluated early lumbar cerebrospinal fluid drainage for clearance of subarachnoid blood, endothelin receptor antagonism and localized nicardipine delivery for vasospasm prevention, and liberal red blood cell transfusion strategies to optimize cerebral oxygen delivery. Advances in multimodal neuromonitoring may facilitate earlier detection and treatment of secondary brain injury. Artificial intelligence models integrating clinical and imaging data have demonstrated promising accuracy for early outcome prediction. New evidence supports an approach to aSAH management extending beyond prevention and treatment of large-vessel vasospasm. Although previous strategies have demonstrated better physiological outcomes, uncertainty remains in their effects on functional outcomes. Future research should focus on targeting the multiple processes underlying secondary brain injury.

PMID:
42944940
Bibliographic data and abstract were imported from PubMed on 28 Oct 2026.

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