The pathophysiology of subarachnoid haemorrhage

Abstract

Aneurysm rupture with subarachnoid haemorrhage is the most devastating complication of intracerebral aneurysms. Grading the severity of the haemorrhage assists with prognostication and assists with decision-making for patient management. Both radiological and clinical grading systems can be predictive of outcomes following subarachnoid haemorrhage. The pathophysiology of, and risk factors for, intracerebral aneurysm formation, growth, and rupture are complicated and poorly understood. In order to make an informed judgement about which patients to treat, it is important to balance the natural history of the condition against each patient’s risks of treatment. Numerous risk factors for aneurysm rupture have been identified, and this quantification of risk continues to be refined. Cerebral vasospasm is a common complication after subarachnoid haemorrhage. The pathological mechanisms of vasospasm involve numerous changes acting in concert to result in ischaemic neurological deficits. Clinical and radiological monitoring allows early detection and treatment to prevent ischaemic neurological deficits.